CMS Price Transparency Data

Blood antibody screen

Facility: Texas Health Presbyterian Hospital Denton

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $129
Cash Discount Price: $158
vs. Medicare Baseline: 2.42x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Texas Health Presbyterian Hospital Denton is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.42x the Medicare baseline. Located in 3000 N I-35, Denton, TX.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $158 (297%)

Insurance Median: $129 (242%)

Cash: $158 (297% of Medicare)

Ins. Median: $129 (242% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 242% of the Medicare baseline (a markup of 142%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$10 - $59	19%
Fort Worth Firefighters	$20 - $168	38%
Amerigroup	$24 - $55	45%
Blue Cross Blue Shield	$24 - $290	45%
Cook Childrens	$24 - $26	45%
Molina	$25 - $55	47%
Superior Wellcare	$25 - $58	47%
Aetna	$26 - $193	49%
Cigna	$43 - $259	81%
American Health	$52	98%
Healthspring	$53	100%
Humana	$54	101%
City Of Fort Worth	$118 - $129	222%
Quick Trip	$151 - $174	284%
Phcs	$175 - $205	329%
Healthsmart	$188 - $231	353%
Multiplan	$219 - $240	411%
Galaxy	$221 - $242	415%
Usa	$221 - $242	415%

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 $158.
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 Texas Health Presbyterian Hospital Denton 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.