CMS Price Transparency Data

Blood antibody screen

Facility: Lecom Medical Center and Behavioral Health Pav

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $78
Cash Discount Price: $78
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Lecom Medical Center and Behavioral Health Pav is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.47x the Medicare baseline. Located in 5515 Peach Street, Erie, PA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $78 (147%)

Insurance Median: $78 (147%)

Cash: $78 (147% of Medicare)

Ins. Median: $78 (147% 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
UnitedHealthcare	$10	19%
Blue Cross Blue Shield	$54 - $76	101%
Healthchoice_Berks	$78	147%
Healthchoice_Blair	$78	147%
Healthchoice_Carbon_Monroe_Pike	$78	147%
Healthchoice_Chester	$78	147%
Healthchoice_Erie	$78	147%
Healthchoice_Lycoming_Clinton	$78	147%
Healthchoice_Northcentral	$78	147%
Healthchoice_Northeast	$78	147%
Healthchoice_Somerset_Bedford	$78	147%
Healthchoice_York_Adams	$78	147%
Medicare (plans)	$78	147%
Upmc_Commercial	$78	147%
Upmc_For_Life	$78	147%
Upmc_For_Life_Hmo_Premier_Rx	$78	147%
Upmc_Partner	$78	147%
Upmc_Value	$78	147%
Upmc_Value_Select	$78	147%
Aetna	$85	160%
Cigna	$107	201%

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 $78.
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 Lecom Medical Center and Behavioral Health Pav 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.