CMS Price Transparency Data

Blood antibody screen

Facility: St Francis Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $75
Cash Discount Price: $149
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at St Francis Memorial Hospital is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.41x the Medicare baseline. Located in 430 North Monitor St, West Point, NE.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$75

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: $149 (280%)

Insurance Median: $75 (141%)

Cash: $149 (280% of Medicare)

Ins. Median: $75 (141% 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.

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
Nebraska Total Care	$57 - $67	107%
UnitedHealthcare	$57 - $143	107%
Molina Healthcare Of Nebraska	$58 - $74	109%
Blue Cross Blue Shield	$66 - $142	124%
Humana	$66	124%
Medica	$66 - $143	124%
Aetna	$69 - $143	130%
Good Samaritan Insurance Plan Of Nebraska	$69	130%
Midlands Choice	$143	269%

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 $149.
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 St Francis 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.