CMS Price Transparency Data

Blood antibody screen

Facility: UPMC Bedford Memorial

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $48
Cash Discount Price: $55
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at UPMC Bedford Memorial is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.90x the Medicare baseline. Located in 10455 Lincoln Highway, Everett, PA.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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: $55 (103%)

Insurance Median: $48 (90%)

Cash: $55 (103% of Medicare)

Ins. Median: $48 (90% 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
Aetna	$4 - $62	8%
Health Partners Plans (Jefferson Health Plan)	$8	15%
Upmc Health Plan	$8 - $43	15%
UnitedHealthcare	$9 - $62	17%
Blue Cross Blue Shield	$10 - $31	19%
Upmc Work Partners	$10	19%
Amerihealth Caritas	$11 - $13	21%
Cigna	$11 - $62	21%
Highmark Wholecare (Prev Gateway)	$11 - $13	21%
Pa Health & Wellness	$11 - $14	21%
Geisinger	$12	23%
Intergroup	$60 - $83	113%
Coventry/First Health	$64	120%
Preferred Healthcare System	$74	139%
Health Coalition Partners	$83	156%
Humana	$83	156%
Private Health Care Systems	$83	156%
Selectcare	$83	156%

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 $55.
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 Bedford Memorial 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.