CMS Price Transparency Data

Blood antibody screen

Facility: Physicians Care Surgical Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $384
  • Cash Discount Price: $307
  • vs. Medicare Baseline: 7.21x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Physicians Care Surgical Hospital is $384. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $307. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 7.21x the Medicare baseline. Located in 454 Enterprise Drive, Royersford, PA.
Cash / Self-Pay
$307

Average discount available for prompt cash payment at this facility.

Insurance Median
$384

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: $307 (577%)
Insurance Median: $384 (721%)
Cash: $307 (577% of Medicare)
Ins. Median: $384 (721% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 721% of the Medicare baseline (a markup of 621%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $50 - $430 94%
Ag Administrators $50 94%
Ag Administrators Inc $50 94%
Allied Benefit Systems $50 94%
Allied Benefits Systems $50 94%
Continental Benefits $50 94%
Coventry $50 94%
Geha $50 94%
Healthez $50 94%
Lucent Health $50 94%
Marpai Health $50 94%
Meritain Health $50 94%
Premier Care Network $50 94%
Trustmark $50 94%
Connecticare $56 105%
Blue Cross Blue Shield $96 - $415 180%
Highmark $96 180%
Aarp $384 721%
Cigna $384 721%
Devon Health Services $384 721%
Gpm Health And Life Insurance Mc Supplement $384 721%
Humana $384 721%
Ibc Security 65 $384 721%
Keystone 65 Hmo $384 721%
Medicare (plans) $384 721%
Pcsh Aarp $384 721%
Personal Choice 65 $384 721%
Shenandoah Life $384 721%
Tricare $384 721%
Unified Health Services $384 721%
UnitedHealthcare $384 - $815 721%
Vibra Health Plan $384 721%
Amerihealth Administrators $415 779%
Amerihealth New Jersey Hmo $415 779%
Carefirst Administrators $415 779%
Empire Plan $415 779%
Horizon Of New Jersey $415 779%
Ibc $415 779%
Ibc - Local $415 779%
Ibc 2021 $415 779%
Ibc Local $415 779%
Independence Administrators $415 779%
Independence Bc $415 779%
Independence Federal $415 779%
Keystone Direct Pos $415 779%
Keystone Healthplan East $415 779%
Keystone Hmo $415 779%
Pcsh Ibc $415 779%
Personal Choice $415 779%
Regence Blue Shield $415 779%
Allsavers $815 1531%
Golden Rule Op $815 1531%
Oxford Health Plan $815 1531%
Oxford Life Insurance Company $815 1531%
Surest $815 1531%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 Enterprise Drive, Royersford, PA 19468
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals