CMS Price Transparency Data

Blood antibody screen

Facility: Pioneer Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $132
Cash Discount Price: $111
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Pioneer Medical Center is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.48x the Medicare baseline. Located in 301 W 7Th Ave, Big Timber, MT.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$132

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: $111 (208%)

Insurance Median: $132 (248%)

Cash: $111 (208% of Medicare)

Ins. Median: $132 (248% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 248% of the Medicare baseline (a markup of 148%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$63 - $115	118%
Health Info Net Mcr Adv	$63	118%
Healtnet Federal-All Plans	$63	118%
Humana	$63 - $128	118%
Triwest Va Pccc-All Plans	$63	118%
UnitedHealthcare	$63 - $132	118%
Rocky Mountain Health Network-All Plans	$97	182%
Allegiance Provider-All Plans	$118	222%
Mountain Health Co-Op Hpn	$122	229%
6 Degrees Health-All Plans	$132	248%
Americas Choice-All Plans	$132	248%
City Of Billings-All Plans	$132	248%
Community Health Ntwk-All Plans	$132	248%
Ebms Select Care Network-All Plans	$132	248%
Fedmed Network-All Plans	$132	248%
First Choice Big Sky-All Plans	$132	248%
First Health-All Plans	$132	248%
Interwest Ppo	$132	248%
Mountain Health Co-Op-All Other Plans	$132	248%
Pacific Source-All Plans	$132	248%
Pacific Steel & Recycling-All Plans	$132	248%
Three Rivers-All Plans	$132	248%
Health Info Net Peak/Equity	$135	254%
Health Info Net Standard-All Other Plans	$135	254%
Mountain Health Co-Op Ppo/Pos	$136	255%
Interwest Health Traditional-All Other Plans	$139	261%

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 $111.
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 Pioneer Medical Center 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.