CMS Price Transparency Data

Blood antibody screen

Facility: Hermann Area District Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $25
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Hermann Area District Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.47x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $30 (56%)
Insurance Median: $25 (47%)
Cash: $30 (56% of Medicare)
Ins. Median: $25 (47% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Coventry - All Plans $3 - $7 6%
Tricare $10 - $29 19%
UnitedHealthcare $10 - $31 19%
American Hlth Mcr Adv- All Plans $11 - $33 21%
Blue Cross Blue Shield $11 - $60 21%
Choicecare Mcr Adv- All Plans $11 - $31 21%
Cigna $11 - $30 21%
Humana $11 - $33 21%
Aetna $12 - $70 23%
Wellcare Mcr Adv - All Plans $12 - $33 23%
Harmony Hp Mcaid- All Plans $15 - $43 28%
Healthcare Usa Mcaid- All Plans $17 - $48 32%
Healthlink Hmo $17 - $48 32%
Ambetter / Centene $18 - $52 34%
Healthlink Ppo - All Other Plans $20 - $56 38%
Multiplan/Phcs - All Plans $20 - $56 38%
Comp Results - All Plans $23 - $67 43%
Three Rivers - All Plans $23 - $67 43%
Care Partners Mcaid- All Plans $26 - $74 49%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals