CMS Price Transparency Data

Blood antibody screen

Facility: Monument Health Rapid City Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $69
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Monument Health Rapid City Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.30x the Medicare baseline. Located in 353 Fairmont Blvd, Rapid City, SD.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $132 (248%)
Insurance Median: $69 (130%)
Cash: $132 (248% of Medicare)
Ins. Median: $69 (130% 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
Humana $10 - $170 19%
Medicare (plans) $10 19%
UnitedHealthcare $10 - $125 19%
Va Black Hills Health Care System 12115 [3081206] $10 19%
Health Partners Sx009 [3081102] $16 - $117 30%
Healthpartners [3081368] $16 30%
Risk Admin Svs [3081167] $16 - $151 30%
Tricare $21 - $53 39%
Minnesota Health Care Programs 12K16 [3081295] $23 - $57 43%
Coresource 38225 [3081146] $49 - $129 92%
Govt Employees Health Assn [3081090] $50 - $125 94%
National Telephone Cooperative Assn 52103 [3081149] $50 - $125 94%
Surest [3081369] $50 - $125 94%
United Medical Resources 39026 [3081194] $50 - $125 94%
Avera Health Plans 46045 [3081018] $55 - $139 103%
Rocky Mountain Admin Llc 83028 [3081168] $60 - $151 113%
Medica (Commercial) 94265 [3081118] $62 - $157 116%
Blue Cross Blue Shield $63 118%
Employee Benefit Management 12X44 [3081079] $64 - $161 120%
Pacificsource Health Plans [3081333] $64 - $161 120%
Aetna $68 - $170 128%
Group And Pension Administrators Inc [3081098] $68 - $170 128%
Multiplan Inc 34080 [3081285] $68 - $170 128%
Sanford Health Plan 91184 [3081174] $68 - $170 128%
Tlc Advantage Llc [3081189] $70 - $178 131%
Fedmed Inc [3081283] $71 - $180 133%
Allied Benefit Systems Inc [3081320] $72 - $181 135%
Cigna $72 - $181 135%
Key Benefit Administrators [3081332] $72 - $181 135%
Meritain Health [3081135] $72 - $181 135%
Midlands Choice 47080 [3081136] $72 - $181 135%
Preferred One 41147 [3081160] $72 - $181 135%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 353 Fairmont Blvd, Rapid City, SD 57701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals