CMS Price Transparency Data

Blood antibody screen

Facility: UPMC St Margaret

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $33
Cash Discount Price: $71
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at UPMC St Margaret is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.62x the Medicare baseline. Located in 815 Freeport Road, Pittsburgh, PA.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $71 (133%)

Insurance Median: $33 (62%)

Cash: $71 (133% of Medicare)

Ins. Median: $33 (62% 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
Upmc Health Plan	$8 - $12	15%
Blue Cross Blue Shield	$9 - $42	17%
UnitedHealthcare	$9	17%
Aetna	$10 - $48	19%
Upmc Work Partners	$10	19%
Highmark Wholecare (Prev Gateway)	$11 - $13	21%
Pa Health & Wellness	$11 - $14	21%
Amerihealth Caritas	$13	24%
Cigna	$33 - $48	62%
Coventry/First Health	$83	156%
Private Health Care Systems	$95	178%
Selectcare	$95	178%
Humana	$101	190%

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 $71.
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 UPMC St Margaret 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.