CMS Price Transparency Data

Blood antibody screen

Facility: Uva Health Culpeper Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $54
Cash Discount Price: $92
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Uva Health Culpeper Medical Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.01x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $92 (173%)

Insurance Median: $54 (101%)

Cash: $92 (173% of Medicare)

Ins. Median: $54 (101% 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
Veterans [99909]	$5	9%
UnitedHealthcare	$8 - $156	15%
Sentara Behavioral Health [40052]	$10 - $41	19%
Sentara [40021]	$10 - $41	19%
Aetna	$12 - $95	23%
Geha [40009]	$12 - $46	23%
Champva [50002]	$19	36%
Tricare	$19	36%
Beacon Health Options [40012]	$40 - $108	75%
Cigna	$40 - $134	75%
Commercial Contracted Hb Only [40056]	$42 - $113	79%
Commercial Generic [40000]	$42 - $150	79%
Carefirst [30007]	$45 - $50	85%
Blue Ridge Pace [10510]	$47	88%
Medicaid / KanCare	$47	88%
Commercial Contracted Tpa [40055]	$48 - $150	90%
Blue Cross Blue Shield	$52 - $156	98%
HMO Part B [10099]	$52	98%
Humana	$52 - $55	98%
Medicare (plans)	$52 - $54	98%
VA Ccn [99926]	$52 - $54	98%
VA Ccn [99927]	$52 - $54	98%
Veterans Administration [99910]	$54	101%
Umwa [40037]	$56 - $150	105%
Healthsmart [40013]	$60 - $161	113%
First Health Generic [40033]	$66 - $176	124%
Gateway Health Alliance [40034]	$68 - $183	128%
Multiplan Generic [40035]	$68 - $183	128%
Vhn Generic [40040]	$68 - $183	128%
Onenet Workers Comp Generic [60010]	$70 - $188	131%

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 $92.
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 Uva Health Culpeper 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.