CMS Price Transparency Data

Blood antibody screen

Facility: Hackensack Meridian Health Pascack Valley Medical

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $85
Cash Discount Price: $73
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Hackensack Meridian Health Pascack Valley Medical is $85. 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 1.60x the Medicare baseline. Located in 250 Old Hook Road, Westwood, NJ.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $85 (160%)

Cash: $73 (137% of Medicare)

Ins. Median: $85 (160% 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
Healthscope Benefits [2290]	$8 - $85	15%
UnitedHealthcare	$8 - $93	15%
Medicare (plans)	$18	34%
Aetna	$22	41%
Black Lung [6055]	$41	77%
Commercial Generic [1285]	$41	77%
Create Flex / Select [3580]	$41	77%
Healthcare Highways [2210]	$41 - $85	77%
Horizon [3625]	$41 - $93	77%
Lucent Health [6000]	$41	77%
Oncology Patient Assistance Programs [2295]	$41	77%
Selecthealth [3740]	$41	77%
Web Tpa [2115]	$41	77%
Worker's Comp [2125]	$41 - $80	77%
Wtc Healthcare Sme Karna [8005]	$41	77%
Magnacare Commercial [3650]	$80	150%
Qualcare [3725]	$84 - $97	158%
Administrative Concepts [1005]	$85	160%
Allied National Global Care [1035]	$85	160%
First Health [1375]	$85	160%
Gilsbar [1425]	$85	160%
Healthcost Solutions [2415]	$85	160%
Healthfirst [2395]	$85	160%
Healthnet [1495]	$85	160%
Hometown Health [2155]	$85	160%
Mayo Clinic Health Solutions [2280]	$85	160%
Multiplan [1680]	$85	160%
Mutual of Omaha [1685]	$85	160%
New Era Life Insurance Company [1705]	$85	160%
PHCS [1780]	$85	160%
Pan American Life Insurance Co [1770]	$85	160%
Pba [1775]	$85	160%
Planned Administrators Inc [2360]	$85	160%
Resource One Administrators [2815]	$85	160%
Trustmark [2030]	$85	160%
Universal Fidelity [2085]	$85	160%
Blue Cross Blue Shield	$93	175%
Emblem Health [2430]	$97	182%
Humana	$97	182%
Amerihealth [3520]	$100	188%

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 Hackensack Meridian Health Pascack Valley Medical 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.