CMS Price Transparency Data

Blood antibody screen

Facility: Brattleboro Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $101
Cash Discount Price: $106
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Brattleboro Memorial Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.90x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $106 (199%)

Insurance Median: $101 (190%)

Cash: $106 (199% of Medicare)

Ins. Median: $101 (190% 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
Blue Cross Blue Shield	$6 - $136	11%
Tufts Health Plan	$11 - $138	21%
Vermont Health Plan	$11 - $135	21%
UnitedHealthcare	$31 - $144	58%
Amerihealth-Caritas	$41	77%
New Hampshire Healthy Families	$41	77%
Wellsense	$41 - $55	77%
Harvard Pilgrim Health Care	$51 - $131	96%
Humana	$51	96%
Martin'S Point	$51	96%
Mvp Healthcare	$51 - $136	96%
Cigna	$53 - $144	100%
New Hampshire Healthy Families (Wellcare)	$54	101%
Multiplan	$56 - $147	105%
Aetna	$147	276%
Coventry	$147	276%
Health New England	$147	276%

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 $106.
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 Brattleboro Memorial Hospital 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.