CMS Price Transparency Data

Blood antibody screen

Facility: UPMC Presbyterian Shadyside

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $91
Cash Discount Price: $136
vs. Medicare Baseline: 1.71x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at UPMC Presbyterian Shadyside is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.71x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $136 (255%)

Insurance Median: $91 (171%)

Cash: $136 (255% of Medicare)

Ins. Median: $91 (171% 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
Health Partners Plans (Jefferson Health Plan)	$8	15%
Blue Cross Blue Shield	$9 - $41	17%
Upmc Health Plan	$9 - $13	17%
UnitedHealthcare	$10 - $11	19%
Upmc Work Partners	$10	19%
Aetna	$11	21%
Amerihealth Caritas	$11 - $13	21%
Cigna	$11	21%
Highmark Wholecare (Prev Gateway)	$11 - $13	21%
Multiplan	$11 - $270	21%
Pa Health & Wellness	$11 - $14	21%
Geisinger	$13	24%
Preferred Healthcare System	$74 - $220	139%
Coventry/First Health	$80 - $237	150%
Fidelis	$86 - $254	162%
Intergroup	$86 - $287	162%
Health Coalition Partners	$91 - $270	171%
Private Health Care Systems	$91 - $270	171%
Selectcare	$91 - $270	171%
Health Payors Organization	$97 - $287	182%
Humana	$97 - $287	182%

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 $136.
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 Presbyterian Shadyside 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.