CMS Price Transparency Data

Blood antibody screen

Facility: Texas Orthopedic Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $31
  • Cash Discount Price: $913
  • vs. Medicare Baseline: 0.58x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Texas Orthopedic Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $913. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.58x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$913

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $913 (1715%)
Insurance Median: $31 (58%)
Cash: $913 (1715% of Medicare)
Ins. Median: $31 (58% 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
American Health Plan $10 19%
Amerigroup $10 - $128 19%
Blue Cross Blue Shield $10 - $320 19%
Cigna $10 - $52 19%
Devoted Health $10 19%
Humana $10 - $106 19%
Integranet Amerigroup Ipa $10 19%
Kelsey Seybold $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 - $55 19%
Triwest Healthcare Alliance $10 19%
United $10 - $411 19%
Van Lang Ipa $10 19%
Wellcare $10 19%
Wellmed $10 19%
Molina $11 21%
Universal Healthcare Group $12 23%
Verda Health Plan $13 24%
Community Health Choice $14 26%
Superior $14 - $15 26%
Corvel Corporation $19 36%
Molina Healthcare $21 39%
Omni Healthcare $21 39%
Healthcare Highways $24 45%
Aetna $31 - $56 58%
Community Health Choice Mcd $119 224%
Texas Childrens Health Plans $152 - $216 285%
Texas Workforce Commission $219 411%
Evry Health $249 468%
Imagine Health $320 601%
Christus (Usfhp) $365 686%
Healthsmart Preferred Care $393 - $776 738%
Averde Health $411 772%
Fidelis Securecare Of Tx $411 772%
Coventry National First Health $487 915%
Physicians Cooperative Of Texas $502 943%
Rockport Workers Comp $502 943%
Independent Medical System $548 1029%
National Healthcare Solutions $548 1029%
Southwest Medical $548 1029%
Coastal Comp $593 1114%
Multiplan $685 - $776 1287%
International Health Insurance $730 1371%
Physicians, Inc $776 1458%
Affiliated Ppo $822 1544%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals