CMS Price Transparency Data

Blood antibody screen

Facility: St Louis Childrens Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $81
Cash Discount Price: $66
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at St Louis Childrens Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.52x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $66 (124%)

Insurance Median: $81 (152%)

Cash: $66 (124% of Medicare)

Ins. Median: $81 (152% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Healthscope Benefits [258]	$12 - $88	23%
UnitedHealthcare	$12 - $82	23%
Aetna	$51 - $87	96%
Blue Cross Blue Shield	$51 - $94	96%
Essence Healthcare [221]	$51	96%
Humana	$51 - $82	96%
Healthlink [225]	$53 - $83	100%
Cigna	$54 - $60	101%
Cox Health [757]	$54	101%
Medica [662]	$54	101%
Apwu Health Plan [216]	$60	113%
Consociate [478]	$60	113%
Nalc Health Benefit Plan [242]	$60	113%
Priority Health [648]	$60	113%
Sarah Bush Lincoln [636]	$60	113%
Allied Benefits [498]	$64 - $87	120%
Hope Trust [806]	$64	120%
Cox Health Systems Insurance Company [220]	$72 - $81	135%
Med-Pay [480]	$72 - $82	135%
Unicare [568]	$72 - $83	135%
Health Alliance [224]	$77	145%
Beechstreet [551]	$82	154%
Detego Health [868]	$82	154%
First Health Commercial [734]	$82	154%
Health Systems Inc [620]	$82	154%
Healthcare Sol Mercy [609]	$82	154%
Multiplan Commercial [737]	$82	154%
Multiplan [240]	$82	154%
Phcs [244]	$82 - $88	154%
Preferred Health Professionals [561]	$83	156%
Coresource [497]	$87	163%
Fmh Benefit Service Inc [222]	$87	163%
Mail Handlers [495]	$87	163%
Medica [661]	$88	165%
Hfn [563]	$94	177%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $66.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Louis Childrens Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.