CMS Price Transparency Data

Blood antibody screen

Facility: El Paso Children's Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $225
Cash Discount Price: $65
vs. Medicare Baseline: 4.23x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at El Paso Children's Hospital is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 4.23x the Medicare baseline. Located in 4845 Alameda Avenue, El Paso, TX.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$225

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: $65 (122%)

Insurance Median: $225 (423%)

Cash: $65 (122% of Medicare)

Ins. Median: $225 (423% 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 423% of the Medicare baseline (a markup of 323%). 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
Blue Cross Blue Shield	$12 - $264	23%
Uh Military Va	$16	30%
Health Net Fed Svcs	$17	32%
Molina Nm	$30	56%
El Paso Health Plans	$54 - $63	101%
El Paso First Health Plan	$84 - $99	158%
Western Sky	$159 - $187	299%
UnitedHealthcare	$215 - $253	404%
Aetna	$216 - $282	406%
Cigna	$236 - $276	443%
Coventry Health Care	$240 - $282	451%
Fortified Provider Network	$240 - $282	451%
Multiplan	$240 - $282	451%

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 $65.
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 El Paso Children's Hospital 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.