CMS Price Transparency Data

Blood antibody screen

Facility: Ohio Valley Surgical Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $4,022
  • Cash Discount Price: $61
  • vs. Medicare Baseline: 75.54x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Ohio Valley Surgical Hospital is $4,022. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 75.54x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$61

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,022

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: $61 (115%)
Insurance Median: $4,022 (7554%)
Cash: $61 (115% of Medicare)
Ins. Median: $4,022 (7554% 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 7554% of the Medicare baseline (a markup of 7454%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $2 - $40,293 4%
UnitedHealthcare $12 - $17,571 23%
Aetna $14 - $20,896 26%
Geha $14 - $20,896 26%
Genworth $14 - $20,896 26%
Mail Handlers $14 - $20,896 26%
Meritain $14 - $20,896 26%
Meritain Heatlh $14 - $20,896 26%
Mhbp $14 - $20,896 26%
Ngs Coresource $14 - $20,896 26%
Nippon Life $14 - $20,896 26%
Pacific Source $14 - $20,896 26%
Personify Health $14 - $20,896 26%
Mmoh $46 - $11,885 86%
Mmo Cin. Hmo $47 - $64 88%
Mmoh (Supermed) $47 88%
Aarp $51 - $11,885 96%
Aarp Supplemental $51 - $11,885 96%
American Continental Insurance $51 - $11,885 96%
American Continental Life $51 - $11,885 96%
American Republic $51 - $11,885 96%
American Retirement $51 - $11,885 96%
Aultcare Primetime Health Plan $51 - $11,885 96%
Bankers Fidelity $51 - $11,885 96%
Bankers Life And Casualty $51 - $11,885 96%
Central States $51 - $11,885 96%
Champus $51 - $11,885 96%
Cigna $51 - $18,817 96%
Communicare Advantage $51 - $11,885 96%
Everest $51 - $11,885 96%
Gateway Health Plan $51 - $11,885 96%
Humana $51 - $11,919 96%
Medicare (plans) $51 - $12,264 96%
Medigold $51 - $11,885 96%
Molina $51 - $11,885 96%
Molina Dual Mcr $51 - $11,885 96%
Molina Marketplace $51 - $11,885 96%
Molina Dual Mcr $51 - $11,885 96%
Molina Mcr $51 - $11,885 96%
Molina Mcr Mcd $51 - $11,885 96%
Molina Mcr+Mcd $51 - $11,885 96%
Patient No Pay $51 - $11,885 96%
Prosperity Supplement $51 - $11,885 96%
Self Pay Imaging $51 - $11,885 96%
Wellcare By Allwell $51 - $11,885 96%
Wraparound Pl Supp $51 - $11,885 96%
The Health Plan $53 - $12,479 100%
Devoted Health $56 - $13,707 105%
Employer Direct $59 - $15,703 111%
Caresource $76 - $17,827 143%
Caresourse $76 - $17,827 143%
Medicaid / KanCare $76 - $17,827 143%
Healthgram $81 - $18,817 152%
Nalc $81 - $18,817 152%
Samba $81 - $18,817 152%
Sbma $81 - $18,817 152%
Unified Group $81 - $18,817 152%
Luminare Health $92 173%
Medben $92 173%
Ohio Health $92 173%
Preferred Health $92 173%
Amerihealth Caritas Of Ohio $3,657 6869%
Buckeye Community Health Plan $4,022 7554%
Molina Mcd $4,084 7671%
Golden Rule $17,571 33003%
Medica $17,571 33003%
Oxford $17,571 33003%
Shl $17,571 33003%
Surest $17,571 33003%
Ushealth $17,571 33003%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals