CMS Price Transparency Data

Blood antibody screen

Facility: Pennsylvania Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $91
  • Cash Discount Price: $215
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Pennsylvania Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.71x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$215

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: $215 (404%)
Insurance Median: $91 (171%)
Cash: $215 (404% 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.

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
Gateway Health Plan $8 - $68 15%
Medicaid / KanCare $8 - $215 15%
Pa Medical Assistance $8 15%
Blue Cross Blue Shield $9 - $215 17%
Ibc Commercial Hpn $9 17%
Keystone Hmo Proactive $9 17%
Keystone Mercy Health Plan $11 21%
Upmc $14 - $215 26%
Aetna $16 - $215 30%
Cigna $17 - $73 32%
UnitedHealthcare $17 - $215 32%
Horizon Nj Health $36 - $38 68%
Pgm - Regie De L'Assurance Maladie Quebec $49 92%
Medicare (plans) $54 - $56 101%
Philadelphia Va Medical Center $54 101%
Tricare $55 103%
Geisinger Health Plan $56 - $173 105%
Health Partners $56 - $215 105%
Humana $56 - $172 105%
Ibc $56 105%
Preferred Health Care Eliance $56 105%
Pa Health And Wellness $57 - $90 107%
Penn Life (Living Independently For Elders) $57 107%
Clover Health Plan $59 111%
Keystone First $60 113%
Us Family Health Plan $63 118%
Pgm - Kuwait Defense $75 - $97 141%
Elap $77 145%
Devon $82 - $97 154%
Qualcare $82 154%
Coventry $86 - $110 162%
Pgm - Chop $86 162%
Wissahickon Hospice $86 162%
Claims Watcher $87 - $98 163%
Oscar Health Plan $93 175%
Healthamerica/Coventry $97 - $105 182%
Centivo $98 184%
Elap Services $101 190%
Olympus $104 195%
First Health Global $108 203%
Urn-Cancer Resource Services $108 203%
Highmark $115 216%
Health Net $129 242%
Pgm - Royal Embassy Of Saudi Arabia $129 242%
Pgm - Embassy Of Qatar $140 263%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $140 263%
Penn Global Medicine $144 270%
Pgm - Embassy Of The United Emirates/Ipc $150 282%
Devon Health Services Inc $172 323%
Health America/Ccn $172 323%
Intergroup $172 323%
Pgm - Kuwait Health Division $172 323%
Pgm - Kuwait Oil $172 323%
Preferred Care $172 323%
Commercial Other $215 404%
Community Behavioral Health $215 404%
International Pfs $215 404%
Quest Behavioral Health $215 404%
United Behavioral Health $215 404%
Workers Compensation $215 404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals