CMS Price Transparency Data

Blood antibody screen

Facility: Fairfield Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $83
Cash Discount Price: $56
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Fairfield Medical Center is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.56x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $56 (105%)

Insurance Median: $83 (156%)

Cash: $56 (105% of Medicare)

Ins. Median: $83 (156% 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
Aetna	$10 - $5,960	19%
Allied Benefit Systems	$10 - $112	19%
Meritain Health	$10 - $112	19%
UnitedHealthcare	$16 - $6,081	30%
Caresource	$26 - $7,906	49%
Medicaid / KanCare	$26	49%
Medical Mutual	$26 - $33,500	49%
Molina	$26 - $10,034	49%
Amerihealth Caritas Ohio	$27	51%
Blue Cross Blue Shield	$27 - $26,250	51%
Buckeye Community Health	$27 - $9,426	51%
Humana	$27 - $5,960	51%
The Health Plan	$40 - $6,079	75%
Quality Care Partners/Ohio Ppo Connect	$42 - $116	79%
The Ohio State Health Plan	$45 - $124	85%
Cigna	$48 - $133	90%
Medicare (plans)	$49 - $5,960	92%
Medigold	$50 - $6,081	94%
Va Ccn	$50 - $6,081	94%
Valor Health Plan	$50 - $6,079	94%
Oscar	$51 - $6,124	96%
Multiplan	$55 - $153	103%
Ohio Healthy	$55 - $151	103%
Miscellaneous Plans	$58 - $161	109%
Bwc	$70 - $8,447	131%

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 $56.
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 Fairfield Medical Center 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.