CMS Price Transparency Data

Blood antibody screen

Facility: St Joseph's University Medical Center Inc

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $71
  • Cash Discount Price: $219
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at St Joseph's University Medical Center Inc is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.33x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$219

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

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: $219 (411%)
Insurance Median: $71 (133%)
Cash: $219 (411% of Medicare)
Ins. Median: $71 (133% 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.

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 - $571 8%
Wellpoint $4 - $62 8%
Blue Cross Blue Shield $7 - $191 13%
Horizon New Jersey Health $7 - $68 13%
Aetna $14 - $126 26%
Oxford $20 - $525 38%
Fidelis Care of New Jersey $44 - $65 83%
Amerihealth $62 - $139 116%
Clover Health $62 116%
Horizon New Jersey Total Care $62 116%
Longevity Health Plan $71 133%
Ambetter / Centene $93 175%
Private Healthcare Systems $142 267%
Magnacare $153 287%
Multiplan $164 308%
Consumer Health Network $197 370%
Oscar $206 387%
Cigna $219 411%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals