CMS Price Transparency Data

Blood antibody screen

Facility: Mercy Health Rehabilitation Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $155
Cash Discount Price: $167
vs. Medicare Baseline: 2.91x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Mercy Health Rehabilitation Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.91x the Medicare baseline. Located in 3180 Belmont Ave, Youngstown, OH.

Cash / Self-Pay

$167

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $167 (314%)

Insurance Median: $155 (291%)

Cash: $167 (314% of Medicare)

Ins. Median: $155 (291% 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 291% of the Medicare baseline (a markup of 191%). 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
Medical Mutual Nas	$15 - $118	28%
Aultcare	$18 - $146	34%
Multiplan	$23 - $181	43%
Aetna	$27 - $215	51%
Ambetter / Centene	$27 - $215	51%
Blue Cross Blue Shield	$27 - $215	51%
Caresource Exchange	$27 - $215	51%
Cigna	$27 - $215	51%
Devoted	$27 - $215	51%
Highmark Ppo Commercial	$27 - $215	51%
Highmark Ppo Exchange	$27 - $215	51%
Humana	$27 - $215	51%
Medicaid / KanCare	$27 - $215	51%
Medical Mutual Exchange	$27 - $215	51%
Medical Mutual Medflex	$27 - $215	51%
Medical Mutual New Biz	$27 - $215	51%
Medical Mutual Supermed Commercial	$27 - $215	51%
Medical Mutual Traditional Commercial	$27 - $215	51%
Medicare (plans)	$27 - $215	51%
Molina Exchange	$27 - $215	51%
UnitedHealthcare	$27 - $215	51%
Upmc	$27 - $215	51%

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 $167.
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 Mercy Health Rehabilitation Hospital 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.