CMS Price Transparency Data

Blood antibody screen

Facility: Wooster Community Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $64
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Wooster Community Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.20x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $85 (160%)
Insurance Median: $64 (120%)
Cash: $85 (160% of Medicare)
Ins. Median: $64 (120% 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
Blue Cross Blue Shield $10 - $25 19%
Buckeye Mcare $10 19%
Caresource Mcr Adv $10 19%
Humana $10 - $80 19%
Med Mutual Of Oh Mcr $10 19%
Molina Mcr $10 19%
Summacare Mcr $10 19%
The Health Plan Mcr Adv $10 19%
Tricare $10 19%
UnitedHealthcare $10 - $81 19%
Valor Hp Mcr-All Plans $10 19%
Magnipower-All Plans $13 24%
Caresource Exch - All Other Plans $14 26%
Molina Marketplace - All Other Plans $17 32%
Clarity Health - All Plans $19 36%
Buckeye Mcaid-All Other Plans $24 45%
Caresource Mcaid $24 45%
Molina Mcaid $25 47%
Aetna $26 - $85 49%
Amerihealth Mcaid-All Plans $26 49%
Aultcare/Primecare Mcr Adv $42 79%
Cerco-All Plans $59 111%
Aultcare Wayne County $64 120%
Aultcare/Primetime Exch $64 120%
Rayco-All Plans $64 120%
Christian Health Ministries-All Plans $68 128%
Cigna $68 128%
Health Ohio Network Employer $68 128%
Wayne County-All Plans $68 128%
Healthsmart Accel $70 131%
Summacare Preferred Choice $70 131%
Health Ohio Network Ppo-All Other Plans $72 135%
Healthsmart Complete Ppo-All Other Plans $72 135%
Ohio Health Choice Supp $72 135%
Ohio Health Group Hlthy - All Other Plans $72 135%
Med Mutual Of Oh Exchange $73 137%
Med Mutual Of Oh Supermed $73 137%
Med Mutual Of Oh Trad-All Other Plans $73 137%
Health Plan Of Upper Ohio-All Plans $75 141%
The Health Plan Comm - All Other Plans $75 141%
Aultcare/Primetime-All Other Plans $76 143%
Ohio Health Group Pref $76 143%
Healthsmart Ppo $77 145%
Summacare-All Other Plans $79 148%
Ohio Health Choice-All Other Plans $80 150%
Healthsmart Hpo $81 152%
Osu-All Plans $81 152%
Beech Street-All Plans $82 154%
Central Benefits-All Plans $82 154%
First Health-All Plans $82 154%
Flora-All Plans $82 154%
Phcs-All Plans $82 154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals