CMS Price Transparency Data

Blood antibody screen

Facility: Strong Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $10
Cash Discount Price: $83
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Strong Memorial Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.19x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$83

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: $83 (156%)

Insurance Median: $10 (19%)

Cash: $83 (156% 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
Medicaid / KanCare	$5 - $15	9%
Blue Cross Blue Shield	$6 - $114	11%
Excellus [2201]	$6	11%
Fidelis [5155]	$6 - $13	11%
Medicare (plans)	$6 - $72	11%
UnitedHealthcare	$6 - $70	11%
Cigna	$7 - $129	13%
Highmark Bc/Bs Of Western Ny [5143]	$7	13%
Molina Healthcare [1723], Molina Healthcare [5189]	$7	13%
Mvp [2900]	$7 - $129	13%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$8 - $33	15%
Independent Health [5156]	$8 - $15	15%
Aetna	$10 - $76	19%
Capital District Physicians Health Plan (Cdphp) [51490]	$10	19%
Capital District Physicians Health Plan (Cdphp) [5149]	$10	19%
Elderplan [1316]	$10	19%
Excellus Bc/Bs [2201]	$10 - $18	19%
Icircle [1728]	$10	19%
Martins Point [1205]	$10 - $65	19%
Nascentia [1729]	$10	19%
Humana	$11 - $81	21%
Molina Healthcare [5189]	$13	24%

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 $83.
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 Strong 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.