CMS Price Transparency Data

Blood antibody screen

Facility: Springfield Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $106
Cash Discount Price: $107
vs. Medicare Baseline: 1.99x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Springfield Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.99x the Medicare baseline. Located in Po Box 2003, Springfield, VT.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $107 (201%)

Insurance Median: $106 (199%)

Cash: $107 (201% of Medicare)

Ins. Median: $106 (199% 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	$35 - $934	66%
Harvard Pilgrim Health Care	$35 - $773	66%
Mvp Health Plan	$35 - $719	66%
UnitedHealthcare	$35 - $841	66%
Wellsense	$35 - $934	66%
Wellcare	$36 - $366	68%
Tufts Health Plan	$56 - $574	105%
Cigna	$64 - $971	120%
Multiplan	$76 - $775	143%
Aetna	$86 - $887	162%
Coventry	$86 - $887	162%
Beacon Health	$91 - $934	171%
Manage Behavioral Health	$91 - $934	171%
Martin'S Point Healthcare	$91 - $934	171%

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 $107.
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 Springfield 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.