CMS Price Transparency Data

Blood antibody screen

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $78
Cash Discount Price: $42
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Cincinnati Children's Hospital Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.47x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $42 (79%)

Insurance Median: $78 (147%)

Cash: $42 (79% of Medicare)

Ins. Median: $78 (147% 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 - $79	19%
Humana	$10 - $44	19%
Passport_Ky	$10	19%
United_Health_Care_Ky	$10	19%
Wellcare_Ky	$10	19%
Blue Cross Blue Shield	$13 - $82	24%
Caresource_In	$13	24%
Mhs_In	$13	24%
Caresource_Oh_Insurance	$40	75%
Cigna	$40 - $79	75%
Caresource_Oh	$42	79%
United_Health_Care_Oh	$44	83%
Amerihealth_Caritas_Oh	$45	85%
Molina_Oh	$46	86%
Buckeye_Oh	$48	90%
Medical_Mutual_Of_Ohio_Insurance	$51 - $79	96%
Point_Comfort_Insurance	$54	101%
Margaret_Mary_Health_Insurance	$65	122%
Parkview_Signature_Care_Insurance	$65	122%
United_Health_Care_Insurance	$74	139%
Health_Ohio_Network_Insurance	$76 - $79	143%
Custom_Design_Benefits_Insurance	$79	148%
Health_Smart_Preferred_Insurance	$79	148%
Medical_Benefit_Administrators_Insurance	$79	148%
Ohio_Health_Choice_Insurance	$79	148%
Private_Health_Care_Systems_Insurance	$80	150%
Beechstreet_Insurance	$81	152%
First_Health_Group_Insurance	$81	152%
Health_Link_Insurance	$81	152%
Evolutions_Health_Care_Systems	$83	156%
Galaxy_Health_Insurance	$83	156%

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 $42.
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 Cincinnati Children's Hospital 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.