CMS Price Transparency Data

Blood antibody screen

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $54
Cash Discount Price: $57
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Independence Health System Butler Memorial Hospita is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. 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 Way, Butler, PA.

Cash / Self-Pay

$57

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: $57 (107%)

Insurance Median: $54 (101%)

Cash: $57 (107% 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.

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	$7 - $118	13%
Medicaid / KanCare	$8	15%
UnitedHealthcare	$8 - $132	15%
Upmc	$8 - $86	15%
Amerihealth	$9 - $54	17%
Gateway	$9 - $86	17%
Geisinger	$9 - $82	17%
Jefferson Health Plan	$9	17%
Highmark	$15 - $108	28%
Highmark - Ind.& Managed Care	$15 - $120	28%
Highmark Aca - Direct Blue	$15 - $68	28%
Highmark Community Blue	$15 - $106	28%
Ellwood Group	$25 - $103	47%
Martin'S Point - Usfhp	$29 - $51	54%
Ccbh - Behavioral Health	$32 - $41	60%
Devoted Health Plan	$33 - $54	62%
Cigna	$41 - $117	77%
Life Butler County	$51	96%
Medicare (plans)	$51	96%
Peak Health	$51 - $121	96%
Provider Partners	$51	96%
Tricare	$51	96%
Workers Comp	$52	98%
Humana	$53	100%
The Health Plan	$54 - $121	101%
Pa Health & Wellness	$55	103%
American Health Plan	$57	107%
Pnoa	$57 - $66	107%
Private Healthcare Systems	$57 - $70	107%
Devon	$62	116%
Intergroup	$66	124%
Multiplan	$74	139%

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 $57.
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 Independence Health System Butler Memorial Hospita 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.