CMS Price Transparency Data

Blood antibody screen

Facility: Hospital of Univ of Pennsylvania

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $152
  • Cash Discount Price: $662
  • vs. Medicare Baseline: 2.85x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Hospital of Univ of Pennsylvania is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $662. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.85x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$662

Average discount available for prompt cash payment at this facility.

Insurance Median
$152

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: $662 (1243%)
Insurance Median: $152 (285%)
Cash: $662 (1243% of Medicare)
Ins. Median: $152 (285% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 285% of the Medicare baseline (a markup of 185%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 - $662 15%
Pa Medical Assistance $8 - $662 15%
Blue Cross Blue Shield $9 - $134 17%
Ibc Commercial Hpn $9 17%
Kaiser Permanente $9 - $662 17%
Keystone Hmo Proactive $9 17%
Keystone Mercy Health Plan $11 - $662 21%
Upmc $14 - $662 26%
Cigna $17 - $298 32%
UnitedHealthcare $17 - $662 32%
Aetna $23 - $662 43%
Gspp And Wissahickon Hospice $27 51%
Paired Kidney Exchange $53 100%
Medicare (plans) $55 - $56 103%
Philadelphia Va Medical Center $55 103%
Tricare $55 103%
Geisinger Health Plan $56 - $174 105%
Health Partners $56 - $662 105%
Humana $56 - $530 105%
Ibc $56 105%
Devoted Health $58 109%
Pa Health And Wellness $58 - $90 109%
Penn Life (Living Independently For Elders) $58 109%
Clover Health Plan $59 111%
Keystone First $61 115%
Us Family Health Plan $63 118%
Gateway Health Plan $68 128%
Elap $78 147%
Claims Watcher $88 - $99 165%
Oscar Health Plan $93 175%
Centivo $99 186%
Elap Services $102 192%
Horizon Nj Health $112 - $116 210%
Highmark $115 216%
Penn Global Medicine $145 272%
Preferred Health Care Eliance $146 274%
Pgm - Regie De L'Assurance Maladie Quebec $152 285%
Pgm - Kuwait Defense $232 - $298 436%
Qualcare $252 473%
Olympus $260 488%
Coventry $265 - $338 498%
Pgm - Chop $265 498%
Wissahickon Hospice $265 498%
Healthamerica/Coventry $298 - $324 560%
First Health Global $331 622%
Health Net $397 746%
Pgm - Royal Embassy Of Saudi Arabia $397 746%
Pgm - Embassy Of Qatar $430 808%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $430 808%
Interlink $444 834%
Pgm - Embassy Of The United Emirates/Ipc $463 870%
Health America/Ccn $530 995%
Intergroup $530 995%
Pgm - Kuwait Health Division $530 995%
Pgm - Kuwait Oil $530 995%
Preferred Care $530 995%
Blue Quality Centers For Transplant (Bqct) $662 1243%
City Of Philadelphia Behavioral Health $662 1243%
Commercial Other $662 1243%
International Pfs $662 1243%
United Behavioral Health $662 1243%
Workers Compensation $662 1243%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals