CMS Price Transparency Data

Blood antibody screen

Facility: Methodist Midlothian Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $65
  • Cash Discount Price: $90
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Methodist Midlothian Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.22x the Medicare baseline. Located in 1201 E Highway 287, Midlothian, TX.
Cash / Self-Pay
$90

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $90 (169%)
Insurance Median: $65 (122%)
Cash: $90 (169% of Medicare)
Ins. Median: $65 (122% 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.

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 $8 - $34 15%
UnitedHealthcare $8 - $56 15%
Aetna $52 - $85 98%
Blue Cross Blue Shield $52 - $55 98%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] $52 98%
Medicare (plans) $52 - $56 98%
Ust Health Proof [1005] $52 98%
Wellcare [7016] $52 98%
American Health Advantage Of Texas [7099] $55 103%
Cigna $55 - $97 103%
Globalhealth [1003] $55 103%
Humana $55 103%
Procare Advantage [7018] $55 103%
Southwestern Health Resources Swhr [7015] $55 103%
Provider Partners Health Plan [7025] $57 107%
Alternative Service Concepts [8005] $65 122%
Oscar Insurance Company [2057] $68 128%
Bright Healthcare [2222] $73 137%
Molina [3017] $76 143%
Wellpoint Marketplace Exchange [3071] $81 152%
Kempton Group Administrators, Tower Extrusions [3061] $84 158%
90 Degree Benefit [3057] $86 162%
Allied National [2031] $86 162%
Entrust/90 Degree [2058] $86 162%
Friday Health Plan [2061] $89 167%
Ambetter / Centene $90 169%
Imperial Insurance Companies [3073] $94 177%
Web Tpa [3049] $97 182%
Department Of Labor [8004] $105 197%
Evry Health [1013] $105 197%
Generic Workers Comp Tx Non Par [9010] $105 197%
Generic Workers Comp Tx Par [8002] $105 197%
Generic Workers Comp Tx Par [9011] $105 197%
Sana Benefits [3069] $105 197%
Tristar Risk Management [8006] $105 197%
Velocity [3070] $105 197%
Health Plans Inc [5017] $131 246%
Medical Cost Containment Professionals [3059] $131 246%
Dart Member Care [3039] $141 265%
Healthscope Benefits [2052] $141 265%
Healthscope Benefits [3063] $141 265%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 E Highway 287, Midlothian, TX 76065
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals