CMS Price Transparency Data

Blood antibody screen

Facility: Novant Health Forsyth Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $175
Cash Discount Price: $175
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Novant Health Forsyth Medical Center is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.29x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$175

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $175 (329%)

Insurance Median: $175 (329%)

Cash: $175 (329% of Medicare)

Ins. Median: $175 (329% 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 329% of the Medicare baseline (a markup of 229%). 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
Carolina Complete	$36 - $57	68%
Nc Department Of Public Safety	$36 - $101	68%
Amerihealth	$37 - $58	69%
Blue Cross Blue Shield	$37 - $222	69%
UnitedHealthcare	$37 - $207	69%
Wellcare	$37 - $58	69%
Humana	$51 - $240	96%
Pace Of The Southern Piedmont	$51	96%
Aetna	$52 - $246	98%
Cigna	$52 - $183	98%
Liberty Health	$53	100%
Caresource North Carolina	$78 - $123	147%
Atlantic Corporation Dba Atlantic Packaging	$110 - $174	207%
Plotkin Health	$116 - $185	218%
Amps	$126 - $200	237%
Medcost	$165 - $290	310%
Primary Physician Care	$171 - $271	321%
Beechstreet	$175 - $277	329%
Multiplan	$175 - $277	329%
Phcs	$175 - $277	329%
Employers Choice Network	$188 - $299	353%
Three Rivers Provider Network	$188 - $299	353%

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 $175.
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 Novant Health Forsyth 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.