CMS Price Transparency Data

Blood antibody screen

Facility: Mt Ascutney Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $209
  • Cash Discount Price: $182
  • vs. Medicare Baseline: 3.93x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mt Ascutney Hospital is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $182. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.93x the Medicare baseline. Located in 289 County Road, Windsor, VT.
Cash / Self-Pay
$182

Average discount available for prompt cash payment at this facility.

Insurance Median
$209

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: $182 (342%)
Insurance Median: $209 (393%)
Cash: $182 (342% of Medicare)
Ins. Median: $209 (393% 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 393% of the Medicare baseline (a markup of 293%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $164 - $202 308%
The Vermont Health Plan $165 310%
Mvp Health Plan, Inc. $207 389%
Cigna $211 396%
Hphc Insurance Company, Inc. $211 396%
Aetna $216 406%
UnitedHealthcare $216 406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 289 County Road, Windsor, VT 05089
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals