CMS Price Transparency Data

Blood antibody screen

Facility: Grove City Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $11
Cash Discount Price: $352
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Grove City Medical Center is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $352. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.21x the Medicare baseline. Located in 631 North Broad Street Ext., Grove City, PA.

Cash / Self-Pay

$352

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $352 (661%)

Insurance Median: $11 (21%)

Cash: $352 (661% of Medicare)

Ins. Median: $11 (21% 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
Highmark	$6 - $106	11%
Aetna	$8 - $109	15%
Amerihealth	$8 - $54	15%
Cigna	$8 - $55	15%
Jefferson Health Plans	$8	15%
Univera	$8 - $12	15%
American Health Plans	$10 - $51	19%
Highmark Wholecare	$10 - $54	19%
Humana	$10 - $54	19%
Life Pittsburgh	$10 - $51	19%
Medicare (plans)	$10 - $53	19%
UnitedHealthcare	$10 - $156	19%
University Of Pittsburgh Medical Center	$10 - $52	19%
Medical Mutual	$11 - $146	21%
Molina	$11 - $56	21%
Pennsylvania Health And Wellness	$13	24%
Geisinger	$14	26%

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 $352.
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 Grove City Medical Center 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.