CMS Price Transparency Data

Blood antibody screen

Facility: Adena Pike Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $38
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 0.71x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Adena Pike Medical Center is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.71x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $25 (47%)
Insurance Median: $38 (71%)
Cash: $25 (47% of Medicare)
Ins. Median: $38 (71% 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
Aetna $12 - $70 23%
Blue Cross Blue Shield $12 - $44 23%
Buckeye Community Health Plan $12 23%
Care Source $12 23%
Humana $12 - $48 23%
Medical Mutual Of Ohio $12 - $32 23%
Medigold $12 23%
Molina $12 23%
Gateway Health $17 32%
Molina Marketplace $20 38%
Care Source Just4Me $22 41%
Sidecar Health $34 64%
Ohio Ppo Connect $36 68%
The Health Plan $36 68%
Cigna $37 69%
Medical Mutual Of Ohio Supermed $38 71%
First Health $40 - $70 75%
Ohio Health Choice $41 77%
Healthsmart $48 90%
Integrated Health Plan $48 90%
Multiplan/Private Healthcare Systems $48 90%
Three Rivers Network $48 90%
UnitedHealthcare $80 150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Dawn Lane, Waverly, OH 45690
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals