CMS Price Transparency Data

Blood antibody screen

Facility: Frio Regional Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $310
  • Cash Discount Price: $246
  • vs. Medicare Baseline: 5.82x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Frio Regional Hospital is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $246. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 5.82x the Medicare baseline. Located in 200 S Ih 35, Pearsall, TX.
Cash / Self-Pay
$246

Average discount available for prompt cash payment at this facility.

Insurance Median
$310

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: $246 (462%)
Insurance Median: $310 (582%)
Cash: $246 (462% of Medicare)
Ins. Median: $310 (582% 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 582% of the Medicare baseline (a markup of 482%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Cigna $77 145%
Amerigroup Texas $81 152%
Superior Health Plan $81 152%
Aetna $264 496%
Blue Cross Blue Shield $303 - $317 569%
UnitedHealthcare $324 609%
Choicecare $352 661%
Humana $352 661%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 S Ih 35, Pearsall, TX 78061
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals