CMS Price Transparency Data

Blood antibody screen

Facility: Essentia Health

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $95
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Essentia Health is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.78x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$150

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $150 (282%)
Insurance Median: $95 (178%)
Cash: $150 (282% of Medicare)
Ins. Median: $95 (178% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medica Access $35 - $72 66%
Healthpartners Care Pmap $51 - $104 96%
Primewest $52 98%
Advocare/Security Health $53 100%
Blue Cross Blue Shield $53 - $181 100%
Freedom Blue Ppo $53 100%
Healthpartners Care Msho / Mcr Adv $53 100%
Imcare Msho Pcc Prime $53 100%
Imcare Msho Ref Req $53 100%
Itasca Med Care $53 100%
Medica Advantage Solutions $53 100%
Medica Msho/Dual Solutions $53 100%
Medica Prime Solution Group $53 100%
Medicare (plans) $53 100%
Nd Va Administration $53 100%
Platinum Blue/Vantage Blue $53 100%
Primewest Msho $53 100%
Secure Blue Msho $53 100%
Ubh Cost Plan $53 100%
Ubh Msho $53 100%
Ucare Msho $53 100%
UnitedHealthcare $53 - $214 100%
Sanford Health Plan $57 - $121 107%
Medica $73 - $165 137%
Medica Uplan $73 - $148 137%
Medica Choice $84 - $170 158%
Ucare $87 - $176 163%
Cigna $88 - $180 165%
Healthpartners $88 - $180 165%
Healthpartners Pcc Prime $88 - $180 165%
Wea $95 - $206 178%
America'S Ppo $102 - $208 192%
Wps $110 - $225 207%
Aetna $112 - $228 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals