CMS Price Transparency Data

Blood antibody screen

Facility: Southern Coos Hospital & Health Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $43
Cash Discount Price: $90
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Southern Coos Hospital & Health Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.81x the Medicare baseline. Located in 900 11Th Street Se, Bandon, OR.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $90 (169%)

Insurance Median: $43 (81%)

Cash: $90 (169% of Medicare)

Ins. Median: $43 (81% 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
Healthnet - All Plans	$4 - $13	8%
Tricare	$26 - $78	49%
Advanced Health - All Plans	$29 - $84	54%
Aetna	$30 - $120	56%
Atrio Mcr Adv - Allplans	$30 - $88	56%
Confederated Tribes - All Plans	$30 - $88	56%
Moda Mcr Adv	$30 - $88	56%
Pacific Source Mcr Adv	$30 - $88	56%
Cigna	$36 - $106	68%
Moda Health Plan - All Other Plans	$40 - $119	75%
Prov Netwrk Of America - All Plans	$41 - $120	77%
Three Rivers - All Plans	$41 - $120	77%
UnitedHealthcare	$41 - $120	77%
Blue Cross Blue Shield	$42 - $124	79%
First Choice - All Plans	$42 - $123	79%
Multiplan - All Plans	$42 - $124	79%
First Health - All Plans	$43 - $127	81%
Pacific Source - All Other Plans	$43 - $127	81%
Providence Preferred - All Plans	$43 - $127	81%

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 $90.
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 Southern Coos Hospital & Health 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.