CMS Price Transparency Data

Blood antibody screen

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $113
Cash Discount Price: $82
vs. Medicare Baseline: 2.12x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Mary Hitchcock Memorial Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.12x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $82 (154%)

Insurance Median: $113 (212%)

Cash: $82 (154% of Medicare)

Ins. Median: $113 (212% 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 212% of the Medicare baseline (a markup of 112%). 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
UnitedHealthcare	$4 - $300	8%
Blue Cross Blue Shield	$6 - $341	11%
Beacon Health Strategies/Carelon	$8 - $48	15%
Amerihealth Caritas Nh	$9 - $44	17%
Granite State Health Plan	$9 - $49	17%
Wellsense Health Plan	$9 - $63	17%
Aetna	$10 - $274	19%
Ambetter / Centene	$10 - $129	19%
Cigna	$10 - $268	19%
Harvard Pilgrim Health Care Of Ne	$10 - $251	19%
Martin'S Point Generations Advantage	$10 - $60	19%
Mvp	$10 - $262	19%
Wellcare Health Plans	$10 - $62	19%
Martin'S Point Health Care	$17 - $135	32%
Mass General Brigham Health Plan	$24 - $243	45%
Tufts Health Plan	$28 - $228	53%
Maine Community Health Options	$125 - $287	235%
Coventry	$171 - $340	321%
First Health/Hcvm	$171 - $340	321%
Phcs	$177 - $352	332%
Corvel	$181 - $360	340%
Ccmsi	$187 - $371	351%

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 $82.
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 Mary Hitchcock 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.