CMS Price Transparency Data

Blood antibody screen

Facility: Columbia Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $23
Cash Discount Price: $32
vs. Medicare Baseline: 0.43x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Columbia Memorial Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.43x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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: $32 (60%)

Insurance Median: $23 (43%)

Cash: $32 (60% of Medicare)

Ins. Median: $23 (43% 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	$10 - $21	19%
Blue Cross Blue Shield	$10 - $123	19%
Cdphp	$10 - $149	19%
Fidelis	$10 - $149	19%
Mvp	$10 - $139	19%
Emblem	$11 - $18	21%
UnitedHealthcare	$12	23%
Magnacare	$14	26%
Empire Plan Nyship	$16	30%
Mvp Commercial	$22 - $74	41%
Multiplan	$27 - $89	51%
Herrington Diversified Pdh	$30 - $95	56%
Medicaid / KanCare	$66	124%
Hamaspik	$90	169%
Blue Shield	$92	173%

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 $32.
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 Columbia 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.