CMS Price Transparency Data

Blood antibody screen

Facility: Elmhurst Hospital Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $71
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Elmhurst Hospital Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.33x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.
Cash / Self-Pay
Unavailable

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%)
Insurance Median: $71 (133%)
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
Aetna $3 - $75 6%
Healthfirst $6 - $160 11%
Elderplan $10 19%
Fidelis $10 - $160 19%
Magnacare $12 23%
Oxford $14 26%
United $14 - $89 26%
Oscar $15 28%
Blue Cross Blue Shield $26 - $160 49%
Centerlight $54 101%
Vaccn $63 118%
Vnsny $63 - $73 118%
Wellcare $65 122%
Centers Plan For Healthy Living $66 124%
Metroplus $66 - $160 124%
Carelon $70 - $71 131%
Amidacare $71 133%
Senior Whole Health $71 133%
United Behavioral Health $71 - $78 133%
Affinity $73 - $160 137%
Carelon (Amida Care) $73 137%
Emblem $79 - $96 148%
Multiplan $86 162%
Local 1199 $91 171%
Villagecare Max $91 171%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals