CMS Price Transparency Data

Blood antibody screen

Facility: Hillsboro Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $67
Cash Discount Price: $130
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Hillsboro Medical Center is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.26x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $130 (244%)

Insurance Median: $67 (126%)

Cash: $130 (244% of Medicare)

Ins. Median: $67 (126% 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
Providence Health Plan	$15 - $58	28%
Pacific Source	$21 - $60	39%
Cigna	$26	49%
Aetna	$27 - $63	51%
Care Oregon	$45 - $68	85%
Intercommunity Health Network	$45	85%
Medicare (plans)	$45 - $68	85%
Kaiser Foundation Hospitals	$46 - $170	86%
Community Health Plan Of Washington	$58 - $253	109%
Samaritan Health Plan	$58	109%
Trillium	$58	109%
Humana	$60 - $61	113%
UnitedHealthcare	$61 - $195	115%
Moda	$64 - $209	120%
Health Net Health Plan Of Oregon, Inc.	$67 - $167	126%
Tuality Health	$104	195%
First Choice	$117 - $202	220%
Coventry First Health	$124 - $215	233%
Blue Cross Blue Shield	$146 - $162	274%
Molina Exchange	$146 - $253	274%

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 $130.
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 Hillsboro 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.