CMS Price Transparency Data

Blood antibody screen

Facility: Primary Children's Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $49
  • Cash Discount Price: $52
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Primary Children's Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.92x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$52

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $52 (98%)
Insurance Median: $49 (92%)
Cash: $52 (98% of Medicare)
Ins. Median: $49 (92% 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
American Health $10 - $39 19%
Health Plan Of Nevada $10 - $26 19%
Healthy U $10 - $30 19%
Molina $10 - $58 19%
Selecthealth $10 - $58 19%
Southwest Behavioral Health $10 - $49 19%
UnitedHealthcare $10 - $58 19%
Donor Connect $25 - $27 47%
Aetna $49 - $58 92%
Awh Connected $49 - $58 92%
Byu Athletics $49 - $58 92%
Campbell Scientific $49 - $58 92%
Cigna $49 - $58 92%
Deseret Mutual $49 - $58 92%
Emi $49 - $58 92%
Emi Health $49 - $58 92%
First Choice $49 - $58 92%
First Choice Of The Midwest $49 - $58 92%
Franklin County $49 - $58 92%
Global Excel $49 - $58 92%
Health Utah $49 - $58 92%
Humana $49 - $58 92%
Hygeia Corporation $49 - $58 92%
Ifit $49 - $58 92%
Juniper Systems $49 - $58 92%
Lw Miller $49 - $58 92%
Managed Care Admin $49 - $58 92%
Medcare International $49 - $58 92%
Motivhealth $49 - $58 92%
Pehp $49 - $58 92%
Prodegi Corp Benefit $49 - $58 92%
Tanner Llc $49 - $58 92%
Uofu $49 - $58 92%
Utah Tech $49 - $58 92%
Wise Network $49 - $58 92%
Blue Cross Blue Shield $50 - $59 94%
First Health $50 - $58 94%
Springtide $50 - $59 94%
Tricare $51 96%
Triwest $51 96%
Utah Behavioral Health Network $56 105%
Altius Mhnet Behavioral Health $61 115%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens