CMS Price Transparency Data

Blood antibody screen

Facility: Adventist Health Portland

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $37
Cash Discount Price: $52
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Adventist Health Portland is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.69x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $52 (98%)

Insurance Median: $37 (69%)

Cash: $52 (98% of Medicare)

Ins. Median: $37 (69% 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
Care Oregon - All Plans	$8	15%
Humana	$10	19%
Kaiser Mcr Adv	$10	19%
Moda Mcr Adv	$10	19%
UnitedHealthcare	$10 - $246	19%
Healthnet Mcr Adv	$11	21%
Aetna	$16	30%
Healthnet Epo/Pos/Ppo	$16	30%
Healthnet Hmo/Pos - All Other Plans	$16	30%
Pacific Source Comm - All Plans	$16	30%
Providence Hp - All Plans	$16	30%
Ah Employee Health Plan - All Plans	$18	34%
Moda Conn Oebb/Syn Pebb	$20	38%
Moda Affinity - All Other Plans	$22	41%
Cigna	$23	43%
Moda Select	$31	58%
Moda Connexus	$35	66%
Healthcare Resources - All Plans	$37	69%
Moda Synergy	$37	69%
Ods - All Plans	$46	86%
Workers Comp	$57	107%
Bc Premera First - All Plans	$82	154%
Worldventure - All Plans	$98	184%
Regence Preferred Mcr Adv	$107	201%
First Choice - All Plans	$114	214%
Regence Ohsu Plus	$120	225%
Multiplan - All Plans	$123	231%
Phcs - All Plans	$123	231%
Regence Mcr Adv	$125	235%
First Health-Coventry - All Plans	$131	246%
Regence - All Other Plans	$133	250%
National Provider Network - All Plans	$144	270%
Health Payors Organization Ltd- All Plans	$148	278%
Kaiser - All Other Plans	$151	284%
Moda Ohsu Ppo/Epo/Hmc	$295	554%

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 $52.
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 Adventist Health Portland 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.