CMS Price Transparency Data

Blood antibody screen

Facility: Forbes Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $11
  • Cash Discount Price: $338
  • vs. Medicare Baseline: 0.21x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Forbes Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $338. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.21x the Medicare baseline. Located in 2570 Haymaker Road, Monroeville, PA.
Cash / Self-Pay
$338

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: $338 (635%)
Insurance Median: $11 (21%)
Cash: $338 (635% 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.

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 $5 - $100 9%
Amerihealth $8 - $54 15%
Cigna $8 - $55 15%
Jefferson Health Plans $8 15%
Univera $8 - $12 15%
Aetna $10 - $146 19%
American Health Plans $10 - $51 19%
Highmark Wholecare $10 - $54 19%
Humana $10 - $54 19%
Life Pittsburgh $10 - $51 19%
Martin'S Point $10 - $51 19%
Medicare (plans) $10 - $53 19%
UnitedHealthcare $10 - $162 19%
Medical Mutual $11 - $150 21%
Molina $11 - $56 21%
Pennsylvania Health And Wellness $13 24%
Geisinger $14 26%
University Of Pittsburgh Medical Center $93 175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2570 Haymaker Road, Monroeville, PA 15146
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals