CMS Price Transparency Data

Blood antibody screen

Facility: Hill Country Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $18
Cash Discount Price: $454
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Hill Country Memorial Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $454. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.34x the Medicare baseline. Located in 1020 South State Highway 16, Fredericksburg, TX.

Cash / Self-Pay

$454

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: $454 (853%)

Insurance Median: $18 (34%)

Cash: $454 (853% 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
Wellmed	$9	17%
Aetna	$10	19%
Blue Cross Blue Shield	$10 - $134	19%
Gonzaba Medical Group	$10	19%
Ilumed	$10	19%
Superior Health	$10 - $23	19%
Triwest	$10	19%
United	$10 - $204	19%
Wellcare	$10	19%
Cigna	$16 - $21	30%
Molina Healthcare	$16	30%
Superior	$16	30%
Healthcare Highways	$23	43%
Community First Health Plans	$55 - $123	103%
Healthsmart Preferred Care	$250	470%
Multiplan	$341 - $386	640%
Triwest Health Alliance	$341	640%

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 $454.
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 Hill Country Memorial Hospital 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.