CMS Price Transparency Data

Blood antibody screen

Facility: Holmes County Hospital and Clinics

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $64
Cash Discount Price: $34
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Holmes County Hospital and Clinics is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.20x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $34 (64%)

Insurance Median: $64 (120%)

Cash: $34 (64% of Medicare)

Ins. Median: $64 (120% 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
United-Lex	$16	30%
United-Options-Lex	$16	30%
Ms-Can-Magnolia-Lex	$42	79%
Ms-Can-Molina-Lex	$42	79%
Ms-Can-Truecare-Lex	$43	81%
Cigna	$49	92%
Tricare	$52	98%
Humana	$53	100%
Mpcn-Lex	$55	103%
Medadv_Uhc-Lex	$58	109%
Firstchoice-Lex	$60	113%
Ambetter / Centene	$64	120%
Medadv_Primewell-Lex	$64	120%
Medicare (plans)	$64	120%
Primewell-Lex	$64	120%
Va_Ccn-Lex	$64	120%
Medadv_Uhcdsnp-Lex	$66	124%
Ppoplus	$66	124%
Wellcare-Lex	$66	124%
Devoted_Health-Lex	$67	126%
Firsthealth-Lex	$68	128%
Multiplan-Lex	$68	128%
Aetna	$72	135%
Phcs-Lex	$76	143%
Advhealth-Lex	$85	160%
Blue Cross Blue Shield	$85	160%
Magnolia-Chip-Lex	$85	160%
Molina-Chip-Lex	$85	160%
Molina_Exchange-Lex	$85	160%
Truecare-Chip-Lex	$85	160%

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 $34.
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 Holmes County Hospital and Clinics 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.