CMS Price Transparency Data

Blood antibody screen

Facility: Seton Medical Center Harker Heights

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $86
Cash Discount Price: $22
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Seton Medical Center Harker Heights is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.62x the Medicare baseline. Located in 850 W Central Texas Expressway, Harker Heights, TX.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $22 (41%)

Insurance Median: $86 (162%)

Cash: $22 (41% of Medicare)

Ins. Median: $86 (162% 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.

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
Medicaid / KanCare	$15 - $236	28%
Blue Cross Blue Shield	$38 - $163	71%
Healthscope Benefits [2290]	$40	75%
UnitedHealthcare	$40 - $86	75%
Aetna	$41 - $126	77%
Bell County Indigent Health Svc [3530]	$42	79%
Healthcare Highways [2210]	$86	162%
Oncology Patient Assistance Programs [2295]	$86	162%
Selecthealth [3740]	$86	162%
Web Tpa [2115]	$86 - $176	162%
Oscar Exchange [6080]	$96	180%
Humana	$144	270%
First Care Commercial [1371]	$165	310%
Allied Benefit Systems Inc [1030]	$176	331%
Cigna	$191	359%

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 $22.
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 Seton Medical Center Harker Heights 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.