CMS Price Transparency Data

Blood antibody screen

Facility: HCA Houston Healthcare Tomball

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $21
  • Cash Discount Price: $425
  • vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at HCA Houston Healthcare Tomball is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $425. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.39x the Medicare baseline. Located in 605 Holderrieth, Tomball, TX.
Cash / Self-Pay
$425

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $425 (798%)
Insurance Median: $21 (39%)
Cash: $425 (798% of Medicare)
Ins. Median: $21 (39% 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
Aetna $10 - $64 19%
American Health Plan $10 19%
Blue Cross Blue Shield $10 - $180 19%
Chc Harris Health $10 19%
Cigna $10 - $52 19%
Devoted Health $10 19%
Humana $10 - $106 19%
Integranet Amerigroup Ipa $10 19%
Oscar $10 - $28 19%
Procare Advantage $10 19%
Provider Partners Health Plan Of Texas $10 19%
Shared Health $10 19%
Superior Health Plan $10 - $31 19%
Triwest Healthcare Alliance $10 19%
United $10 - $231 19%
Van Lang Ipa $10 19%
Wellcare $10 19%
Wellmed $10 19%
Molina $11 21%
Verda Health Plan $13 24%
Community Health Choice $14 26%
Superior $14 - $15 26%
Molina Healthcare $21 39%
Healthcare Highways $24 45%
Community Health Choice Mcd $44 - $67 83%
Evry Health $92 - $140 173%
Coventry National First Health $123 - $187 231%
Christus (Usfhp) $135 - $205 254%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 605 Holderrieth, Tomball, TX 77375
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals