CMS Price Transparency Data

Blood antibody screen

Facility: Ira Davenport Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $80
Cash Discount Price: $77
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Ira Davenport Memorial Hospital is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.50x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $77 (145%)

Insurance Median: $80 (150%)

Cash: $77 (145% of Medicare)

Ins. Median: $80 (150% 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
Empire	$4	8%
Amerihealth Caritas Mcr Adv - All Plans	$10	19%
Blue Cross Blue Shield	$10 - $387	19%
Humana	$10 - $115	19%
Tricare	$10	19%
UnitedHealthcare	$22 - $134	41%
Fidelis	$56	105%
Fidelis Care - Exchange - All Plans	$70	131%
Geisinger - All Plans	$74	139%
Cigna	$80	150%
Mvp Health Plan - All Plans	$80	150%
Independent Health - All Plans	$83	156%
Upmc - All Plans	$88	165%
Pomco Inc - All Plans	$92	173%
Aetna	$96 - $114	180%
Emblem Health - All Plans	$112	210%
Emblem/Ghi	$118	222%
Martins Point - All Plans	$128	240%
Healthnow - All Plans	$421	791%

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 $77.
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 Ira Davenport 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.