CMS Price Transparency Data

Blood antibody screen

Facility: Daniels Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $146
Cash Discount Price: $202
vs. Medicare Baseline: 2.74x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Daniels Memorial Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.74x the Medicare baseline. Located in 105 5Th Ave E, Scobey, MT.

Cash / Self-Pay

$202

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $202 (379%)

Insurance Median: $146 (274%)

Cash: $202 (379% of Medicare)

Ins. Median: $146 (274% 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 274% of the Medicare baseline (a markup of 174%). 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
Allegiance Comml-All Other Plans	$8 - $231	15%
Allegiance Mcr	$8 - $146	15%
First Choice Health -All Plans	$9	17%
Triwest Ccn-All Plans	$10 - $146	19%
Blue Cross Blue Shield	$13 - $212	24%
UnitedHealthcare	$13 - $228	24%
Geha - All Plans	$134 - $202	252%
Montana Health Co-Op Hpn	$137 - $207	257%
Montana Health Co-Op-All Other Plans	$153 - $231	287%
Pacific Source Comml-All Plans	$153 - $231	287%
Interwest Ppo - All Plans	$156 - $236	293%

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 $202.
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 Daniels Memorial 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.