CMS Price Transparency Data

Blood antibody screen

Facility: Alice Peck Day Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $63
Cash Discount Price: $56
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Alice Peck Day Memorial Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.18x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $56 (105%)

Insurance Median: $63 (118%)

Cash: $56 (105% of Medicare)

Ins. Median: $63 (118% 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
Ambetter / Centene	$10	19%
Amerihealth Caritas Granite Mcmp	$11	21%
Medicaid / KanCare	$11	21%
Nh Healthy Families	$11	21%
Blue Cross Blue Shield	$35 - $122	66%
Harvard Pilgrim	$44 - $119	83%
UnitedHealthcare	$50 - $99	94%
Tufts	$51 - $100	96%
Cigna	$54 - $112	101%
Commercial Generic	$54 - $105	101%
Connecticut General	$54 - $105	101%
Klais	$54 - $106	101%
Wellpoint	$57	107%
Aetna	$63 - $123	118%
Mvp	$64 - $125	120%
Coventry Health	$66 - $130	124%
Coventry Health Wc	$66 - $130	124%
Humana	$73 - $142	137%

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 $56.
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 Alice Peck Day 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.