CMS Price Transparency Data

Blood antibody screen

Facility: Southern Hills Hospital and Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $10
Cash Discount Price: $118
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Southern Hills Hospital and Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.19x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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: $118 (222%)

Insurance Median: $10 (19%)

Cash: $118 (222% of Medicare)

Ins. Median: $10 (19% 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
Aetna	$1 - $16	2%
Ambetter / Centene	$3 - $10	6%
Caresource	$3	6%
Community Care Health	$3	6%
Molina Healthcare	$3	6%
Sierra Hpn	$3	6%
Humana	$9 - $10	17%
Alignment Health Plan	$10	19%
Blue Cross Blue Shield	$10 - $12	19%
Caremore	$10	19%
Health Services Coalition	$10	19%
Hometown Health Mcr	$10	19%
Select Health	$10 - $27	19%
Sierra	$10	19%
Triwest	$10	19%
United	$10 - $26	19%
Imperial Nv	$11	21%
Universal Healthcare	$12	23%
Cigna	$25	47%
Corvel	$33	62%
Olympus Medsave Usa	$34 - $88	64%
Prominence Healthfirst	$35	66%
Cmn Global	$50	94%
Evernorth	$59	111%
Hometown Health Providers	$59	111%
Nv Health & Welfare Trust	$71	133%
Multiplan	$74 - $86	139%
First Health	$78 - $94	147%
Medcare International	$88	165%

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 $118.
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 Southern Hills Hospital and Medical Center 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.