CMS Price Transparency Data

Blood antibody screen

Facility: Lee County Community Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $19
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 0.36x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Lee County Community Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.36x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $20 (38%)
Insurance Median: $19 (36%)
Cash: $20 (38% of Medicare)
Ins. Median: $19 (36% 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
Aetna $7 - $85 13%
Blue Cross Blue Shield $7 - $85 13%
Molina Healthcare $7 - $19 13%
Optima Health $7 13%
UnitedHealthcare $7 - $19 13%
Ambetter / Centene $19 36%
Amerigroup $19 - $85 36%
Humana $19 36%
Managed Medicaire $19 36%
Medicare (plans) $19 36%
Mountain Empire Pace $19 36%
Sentara Health $19 - $22 36%
United Mine Workers Of America $19 36%
Cigna $20 - $85 38%
Devoted Health Plan $20 38%
Nhc Advantage $20 38%
Seven Corners, Inc. $45 85%
First Health Coventry $85 160%
Medcost $85 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 127 Health Care Drive, Pennington Gap, VA 24277
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals