CMS Price Transparency Data

Blood antibody screen

Facility: Cherry County Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $137
Cash Discount Price: $141
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Cherry County Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.57x the Medicare baseline. Located in 510 North Green St, Valentine, NE.

Cash / Self-Pay

$141

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $141 (265%)

Insurance Median: $137 (257%)

Cash: $141 (265% of Medicare)

Ins. Median: $137 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Ambetter / Centene	$1	2%
Molina Mcr Adv	$77	145%
Molina Mcaid - All Other Plans	$88	165%
Blue Cross Blue Shield	$136	255%
Midlands Choice-All Plans	$136	255%
UnitedHealthcare	$136	255%
Avera Aca Ppo	$137	257%
Avera Aso Ppo	$137	257%
Avera Hmo	$137	257%
Avera Non-Aca Ppo - All Other Plans	$137	257%
First Choice-All Plans	$137	257%
Multiplan-All Plans	$137	257%
Phcs-All Plans	$137	257%
Tlc Advantage-All Plans	$137	257%

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 $141.
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 Cherry County 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.