CMS Price Transparency Data

Blood antibody screen

Facility: St Luke's Hospital - Monroe Campus

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $18
Cash Discount Price: $83
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at St Luke's Hospital - Monroe Campus is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.34x the Medicare baseline. Located in 100 St Luke's Lane, Stroudsburg, PA.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

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: $83 (156%)

Insurance Median: $18 (34%)

Cash: $83 (156% of Medicare)

Ins. Median: $18 (34% 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
Aetna	$10 - $36	19%
Amerihealth Caritas	$10	19%
Blue Cross Blue Shield	$10 - $38	19%
Geisinger	$10 - $28	19%
Highmark	$10 - $24	19%
Highmark Wholecare	$10	19%
Humana	$10	19%
Upmc Health Plan	$10 - $27	19%
UnitedHealthcare	$11 - $34	21%
Jefferson Health Plan	$12	23%
Oscar	$26	49%
Cigna	$27	51%

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 $83.
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 St Luke's Hospital - Monroe Campus 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.