CMS Price Transparency Data

Blood antibody screen

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $41
Cash Discount Price: $129
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at The University of Vermont Health Network-Alice Hy is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.77x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$129

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $129 (242%)

Insurance Median: $41 (77%)

Cash: $129 (242% of Medicare)

Ins. Median: $41 (77% 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
Capital District Physicians' Health Plan	$7 - $121	13%
Blue Cross Blue Shield	$10 - $41	19%
Aetna	$41 - $111	77%
Choicecare	$41 - $97	77%
Fidelis Care	$41	77%
Humana	$41	77%
Martins Point	$41	77%
Mvp	$41 - $107	77%
St. Regis	$41	77%
UnitedHealthcare	$41 - $127	77%
Veterans Affairs Community Care Network	$41	77%
Magnacare	$103	193%
Highmark Blueshield	$116	218%

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 $129.
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 The University of Vermont Health Network-Alice Hy 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.