CMS Price Transparency Data

Blood antibody screen

Facility: North Austin Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $29
  • Cash Discount Price: $576
  • vs. Medicare Baseline: 0.54x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at North Austin Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $576. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.54x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$576

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $576 (1082%)
Insurance Median: $29 (54%)
Cash: $576 (1082% of Medicare)
Ins. Median: $29 (54% 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
Wellmed $9 17%
Aetna $10 19%
American Health Plan Of Texas $10 19%
Blue Cross Blue Shield $10 - $244 19%
Cigna $10 - $27 19%
Devoted Health $10 19%
Humana $10 19%
Odyssey Hospice $10 19%
Provider Partners Health Plan $10 19%
Pyramid Life $10 19%
Shared Health $10 19%
St David’S Hospice $10 19%
Superior Health Plan $10 - $98 19%
Texas Independent Health Plan $10 19%
Triwest Healthcare Alliance $10 19%
United $10 - $259 19%
UnitedHealthcare $10 - $259 19%
Wellcare $10 19%
Imperial Insurance $11 21%
Molina Healthcare $11 21%
Austin Fc $12 23%
Universal Health $12 23%
Sendero $13 - $17 24%
Naphcare $15 28%
Seven Corners $15 28%
Amerigroup $17 32%
Corvel Corporation $19 36%
Oscar $27 - $30 51%
Moda $135 254%
Covenant Management Systems $166 312%
Healthcare Highways $168 - $173 316%
Imo Med - Select Network $173 325%
Nomi Health $184 - $213 346%
Moda Health $207 - $213 389%
Evry Health $212 398%
Texas Healthcare Foundation Heb $213 400%
Texas Workforce Commission $225 423%
Harbor Health Team $230 432%
Averde Health $259 486%
Comanche County $288 541%
National Choicecare $288 541%
Healthsmart Preferred Care $317 - $461 595%
Independent Medical Systems $317 595%
Physicians Cooperative Of Texas $317 595%
Prime Health $346 650%
First Health $360 - $409 676%
Coastal Comp Health Networks $374 702%
National Health Care $374 702%
Texas Municipal League $403 757%
Medcorp Southwest $432 811%
Rockport Healthcare Group $461 - $518 866%
Bce Emergis Corporation $518 973%
Beech Street $518 973%
Medical Control Network Solutions $518 973%
Multiplan $518 973%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals