CMS Price Transparency Data

Blood antibody screen

Facility: Cook Childrens Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $195
Cash Discount Price: $312
vs. Medicare Baseline: 3.66x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Cook Childrens Medical Center is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $312. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.66x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.

Cash / Self-Pay

$312

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $312 (586%)

Insurance Median: $195 (366%)

Cash: $312 (586% of Medicare)

Ins. Median: $195 (366% 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 366% of the Medicare baseline (a markup of 266%). 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
Beacon	$20 - $506	38%
Firstcare	$20 - $919	38%
Health Plan W/O Uhrip	$20 - $384	38%
Health Plan W. Uhrip	$28 - $437	53%
Rightcare	$28 - $506	53%
United Community	$29 - $404	54%
Wellpoint	$29 - $404	54%
Blue Cross Blue Shield	$30 - $1,034	56%
Molina	$31 - $425	58%
El Paso Health First	$37 - $506	69%
Superior Health	$37 - $506	69%
Tx Children Health	$37 - $506	69%
UnitedHealthcare	$37 - $977	69%
Aetna	$40 - $977	75%
S&W Health	$70 - $965	131%
Cigna	$71 - $977	133%
Healthscope	$71 - $977	133%
Imagine Health	$71 - $977	133%
Humana	$72 - $1,011	135%
Multiplan	$72 - $1,000	135%
First Health	$73 - $1,011	137%
Galaxy Health	$75 - $1,034	141%
Healthsmart	$75 - $1,034	141%
Usamco	$76 - $1,057	143%

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 $312.
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 Cook Childrens Medical Center 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.