CMS Price Transparency Data

Blood antibody screen

Facility: Clarion Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $54
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Clarion Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.01x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $69 (130%)
Insurance Median: $54 (101%)
Cash: $69 (130% of Medicare)
Ins. Median: $54 (101% 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.

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
Medicaid / KanCare $8 15%
Upmc $8 - $62 15%
Amerihealth $9 - $51 17%
Jefferson Health Plan $9 17%
Geisinger $10 - $54 19%
Highmark $42 - $85 79%
Highmark - Ind.& Managed Care $42 - $115 79%
Martin'S Point - Usfhp $43 - $51 81%
Gateway $46 - $55 86%
Devoted Health Plan $49 - $54 92%
Cigna $51 - $62 96%
Highmark Community Blue $51 96%
Medicare (plans) $51 96%
Tricare $51 96%
UnitedHealthcare $51 96%
Aetna $53 - $118 100%
The Health Plan $54 - $121 101%
Pa Health & Wellness $55 103%
American Health Plan $57 107%
Peak Health $86 - $121 162%
Devon $92 173%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals