CMS Price Transparency Data

Blood antibody screen

Facility: Baylor Scott & White Medical Center Plano

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $114
Cash Discount Price: $127
vs. Medicare Baseline: 2.14x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Baylor Scott & White Medical Center Plano is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.14x the Medicare baseline. Located in 4700 Alliance Boulevard, Plano, TX.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $127 (239%)

Insurance Median: $114 (214%)

Cash: $127 (239% of Medicare)

Ins. Median: $114 (214% 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 214% of the Medicare baseline (a markup of 114%). 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
Superior Health Plan	$10 - $56	19%
UnitedHealthcare	$10 - $194	19%
Baylor Scott & White Health Plan	$25 - $161	47%
Cigna	$25 - $161	47%
Aetna	$28 - $153	53%
Employers Health Network	$28 - $153	53%
Quiktrip	$28 - $153	53%
University Of Mary Hardin-Baylor	$30 - $161	56%
Independent Medical System	$31 - $167	58%
Imagine Health	$32 - $174	60%
Curative	$33 - $180	62%
First Health	$36 - $194	68%
Healthsmart	$36 - $208	68%
Humana	$36 - $194	68%
Private Health Care System	$38 - $208	71%
Triwest	$50	94%
American Health Plan	$52	98%
Blue Cross Blue Shield	$52 - $242	98%
Corvel	$52	98%
Healthspring	$52	98%
Prime Health Services	$52	98%
Procare Advantage	$52	98%
Ambetter / Centene	$103	193%

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 $127.
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 Baylor Scott & White Medical Center Plano 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.