CMS Price Transparency Data

Blood antibody screen

Facility: Carolina East Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $108
Cash Discount Price: $89
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Carolina East Medical Center is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.03x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$108

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: $89 (167%)

Insurance Median: $108 (203%)

Cash: $89 (167% of Medicare)

Ins. Median: $108 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Humana	$10	19%
Inclusive Health (Nchirp)-All Plans	$10	19%
Pamlico Co Jail-All Plans	$39	73%
Craven Co. Jail Systems - All Plans	$50	94%
Medcost Ppo Ultra (Employees)	$93	175%
Medcost Ppo Employees And Retirees	$97	182%
Blue Cross Blue Shield	$102	192%
UnitedHealthcare	$105	197%
Medcost Ppo City Employees	$108	203%
Medcost Ppo County Employee	$112	210%
Benefit Mgmt, Svcs-All Plans	$126	237%
Aetna	$131	246%
Medcost Benefit Svc-All Other Plans	$131	246%
Acs Consult Svc Inc-All Plans	$134	252%
Medcost Ppo Standard	$134	252%
Cigna	$135	254%
Tricare	$148	278%

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 $89.
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 Carolina East 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.