CMS Price Transparency Data

Blood antibody screen

Facility: St Luke's Sugar Land Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $145
Cash Discount Price: $128
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at St Luke's Sugar Land Hospital is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.72x the Medicare baseline. Located in 1317 Lake Pointe Parkway, Sugar Land, TX.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$145

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: $128 (240%)

Insurance Median: $145 (272%)

Cash: $128 (240% of Medicare)

Ins. Median: $145 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
United	$15 - $172	28%
Cigna	$23 - $256	43%
Renaissance	$39	73%
Kelsey	$44	83%
Blue Cross Blue Shield	$54 - $254	101%
Humana	$54 - $237	101%
Selectcare	$54	101%
Aetna	$55 - $248	103%
Amerivantage	$55	103%
UnitedHealthcare	$55 - $302	103%
Devoted	$57	107%
Scanhealth	$57	107%
Kindred	$59	111%
Kelseycare	$72	135%
Community Health Choice	$80	150%
Superior Health Plan	$80	150%
Wellpoint	$80	150%
Bright Health	$83	156%
Tchpchip	$128 - $157	240%
Nx Health	$174	327%
Chc	$201	378%
Texastruechoice	$201	378%
Coventry	$237	445%
First Health	$237	445%
Healthsmart	$256	481%
Interlink	$256	481%
Multiplan	$274	515%
USA Health Network	$310	582%
Mhealth Network	$365	686%

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 $128.
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 St Luke's Sugar Land 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.