CMS Price Transparency Data

Blood antibody screen

Facility: Methodist Celina Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $56
Cash Discount Price: $90
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Methodist Celina Medical Center is $56. 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 1.05x the Medicare baseline. Located in 1500 S Dallas Parkway, Celina, TX.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $56 (105%)

Cash: $90 (169% of Medicare)

Ins. Median: $56 (105% 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	$9	17%
Blue Cross Blue Shield	$49 - $91	92%
Champva [1000]	$51	96%
Tricare	$51	96%
Triwest Wps [8010]	$51	96%
Veterans Administration [9001]	$51	96%
Aetna	$52 - $85	98%
Mcs Advantage, Inc Classicare [7021]	$52	98%
Medicare (plans)	$52 - $56	98%
UnitedHealthcare	$52 - $55	98%
Ust Health Proof [1005]	$52	98%
Wellcare [7016]	$52	98%
American Health Advantage Of Texas [7099]	$55	103%
Cigna	$55	103%
Humana	$55	103%
Southwestern Health Resources Swhr [7015]	$55	103%
Oscar Insurance Company [2057]	$68	128%
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%
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%
Velocity [3070]	$105	197%
Health Plans Inc [5017]	$131	246%
Medical Cost Containment Professionals [3059]	$131	246%

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 $90.
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 Methodist Celina 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.