CMS Price Transparency Data

Blood antibody screen

Facility: Shriners Hospitals for Children - Philadelphia

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $13
Cash Discount Price: $91
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Shriners Hospitals for Children - Philadelphia is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.24x the Medicare baseline. Located in 3551 N Broad Street, Philadelphia, PA.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $91 (171%)

Insurance Median: $13 (24%)

Cash: $91 (171% of Medicare)

Ins. Median: $13 (24% 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
Blue Cross Blue Shield	$6 - $11	11%
Aetna	$8 - $54	15%
Ambetter / Centene	$8 - $62	15%
Amerihealth Mercy Health Plans	$8	15%
Gateway Health Plan	$8	15%
Geisinger Health Plan	$8	15%
Health Partners Of Philadelphia	$8	15%
Keystone Mercy Health Plans	$8	15%
Upmc Health Plan	$8	15%
Cigna	$9	17%
Soonercare	$9	17%
Providence Health Plan	$10	19%
Amerihealth Caritas Of Nc	$21	39%
Wellcare Of North Carolina	$21	39%
Humana	$35	66%
Amerihealth Caritas Nc	$62	116%
Amerihealth Caritas Sc	$62	116%
Sana Benefits	$75	141%

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 $91.
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 Shriners Hospitals for Children - Philadelphia 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.