CMS Price Transparency Data

Blood antibody screen

Facility: Northwest Surgical Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $99
Cash Discount Price: $150
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Northwest Surgical Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.86x the Medicare baseline. Located in 9204 North May Avenue, Oklahoma City, OK.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $150 (282%)

Insurance Median: $99 (186%)

Cash: $150 (282% of Medicare)

Ins. Median: $99 (186% 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
UnitedHealthcare	$9	17%
Blue Cross Blue Shield	$19	36%
Cigna	$26 - $59	49%
Aetna	$83 - $101	156%
Healthchoice	$91	171%
First Health	$97	182%
Medica	$135	254%
Global Health	$161	302%
Community Care	$188	353%
Healthcare Highways	$188	353%
Humana	$225	423%
Phcs	$262	492%
Preferred Community Choice	$262	492%

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 $150.
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 Northwest Surgical 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.