CMS Price Transparency Data

Blood antibody screen

Facility: Atrium Health Cleveland

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $113
Cash Discount Price: $113
vs. Medicare Baseline: 2.12x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Atrium Health Cleveland is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.12x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $113 (212%)

Insurance Median: $113 (212%)

Cash: $113 (212% of Medicare)

Ins. Median: $113 (212% 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 212% of the Medicare baseline (a markup of 112%). 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
Trillium	$14 - $33	26%
Alliance	$15 - $38	28%
Amerihealth Caritas	$15 - $32	28%
Carolina Complete Health	$15 - $32	28%
Healthy Blue	$15 - $32	28%
Partners	$15 - $32	28%
UnitedHealthcare	$15 - $120	28%
Vaya	$15 - $33	28%
Wellcare	$15 - $32	28%
Humana	$51	96%
Aetna	$52 - $174	98%
Cigna	$53 - $180	100%
Blue Cross Blue Shield	$70 - $92	131%
Ambetter / Centene	$72 - $82	135%
Employers Health Network	$100 - $120	188%
Physician Reach Out	$113	212%
Medcost	$126 - $150	237%
Magellan	$135	254%
Gmmi	$147	276%
Quik Trip	$147	276%
Carolina Behavioral Health	$162 - $180	304%
Healthgram	$180	338%
Choicecare	$185	347%
First Health	$192	361%
Lifesynch Community Choice Care	$192	361%
Private Health Care Systems	$203	381%
Beechstreet	$208	391%
Multiplan	$214	402%

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 $113.
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 Atrium Health Cleveland 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.