CMS Price Transparency Data

Blood antibody screen

Facility: Ogallala Community Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $104
Cash Discount Price: $73
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Ogallala Community Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.95x the Medicare baseline. Located in 2601 North Spruce St, Ogallala, NE.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $73 (137%)

Insurance Median: $104 (195%)

Cash: $73 (137% of Medicare)

Ins. Median: $104 (195% 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
UnitedHealthcare	$10 - $111	19%
Banner Health	$48 - $51	90%
Blue Cross Blue Shield	$48 - $112	90%
Medica	$48 - $112	90%
Triwest Healthcare Alliance Corp - Va Ccn	$48 - $51	90%
Molina Healthcare	$53 - $57	100%
Nebraska Total Care	$53 - $57	100%
Keith County Sheriff’S Office	$81 - $88	152%
Apostrophe, Inc.	$97 - $105	182%
Coventry	$104 - $112	195%
First Health	$104 - $112	195%
Midlands Choice	$104 - $112	195%
Multiplan	$105 - $113	197%

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 $73.
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 Ogallala Community 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.