CMS Price Transparency Data

Blood antibody screen

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $318
Cash Discount Price: $163
vs. Medicare Baseline: 5.97x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Crystal Clinic Orthopaedic Center is $318. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 5.97x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$163

Average discount available for prompt cash payment at this facility.

Insurance Median

$318

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: $163 (306%)

Insurance Median: $318 (597%)

Cash: $163 (306% of Medicare)

Ins. Median: $318 (597% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 597% of the Medicare baseline (a markup of 497%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Bc Mcr Adv	$10	19%
Summacare Mcr Adv	$10	19%
UnitedHealthcare	$10 - $457	19%
The Health Plan - All Plans	$20	38%
Aultcare - All Plans	$69	130%
Health Oh Network - All Plans	$130	244%
Ohio Health Choice - All Plans	$130	244%
Med Mutual Nas	$135	254%
Multiplan - All Plans	$143	269%
Healthsmart - All Plans	$184	346%
Bc Pathway	$271	509%
Cigna	$365	686%
Bc Ohi/Ohii	$372	699%
Summacare Comm - All Other Plans	$401	753%
Med Mutual Medflex	$406	763%
Bc Blue Access	$414	778%
Bc Preferred	$414	778%
Bc Trad - All Other Plans	$414	778%
Med Mutual Aca	$462	868%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$508	954%
Aetna	$514	965%

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 $163.
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 Crystal Clinic Orthopaedic 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.