CMS Price Transparency Data

Blood antibody screen

Facility: Carilion Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $185
Cash Discount Price: $125
vs. Medicare Baseline: 3.47x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Carilion Medical Center is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.47x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$185

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: $125 (235%)

Insurance Median: $185 (347%)

Cash: $125 (235% of Medicare)

Ins. Median: $185 (347% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 347% of the Medicare baseline (a markup of 247%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$4 - $190	8%
Sentara Health Plan	$4 - $221	8%
Abh Of Va (Formerly Coventry)	$5	9%
Abh Of Wva (Formerly Coventry)	$5	9%
Humana	$5 - $50	9%
UnitedHealthcare	$5 - $292	9%
Aetna	$46 - $237	86%
Gateway - Tier 3	$196	368%
Vhn - Ultra	$221	415%
Cigna	$241 - $257	453%
Connecticare	$250	470%
Vhn - Plus	$275	517%
Gateway - Tier 2	$286	537%
Vhn	$286	537%
Vhn - Link	$321	603%
Gateway - Tier 1	$339	637%
Vhn - Secondary Payors	$339	637%

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 $125.
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 Carilion 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.