CMS Price Transparency Data

Blood antibody screen

Facility: East Adams Rural Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $100
Cash Discount Price: $84
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at East Adams Rural Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.88x the Medicare baseline. Located in 903 South Adams, Ritzville, WA.

Cash / Self-Pay

$84

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $84 (158%)

Insurance Median: $100 (188%)

Cash: $84 (158% of Medicare)

Ins. Median: $100 (188% 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
Aetna	$87 - $101	163%
Molina Mcaid	$93	175%
Ambetter / Centene	$95	178%
Coordinated Care Mcaid	$95	178%
Amerigroup Mcaid-All Plans	$98	184%
Premera First-All Plans	$99	186%
Assured Hospice Mcr-All Plans	$100	188%
Asuris Nw Hlth Mcr Adv	$100	188%
Molina Markeplace-All Other Plans	$100	188%
Molina Mcr Adv	$100	188%
Triwest Va-All Plans	$100	188%
UnitedHealthcare	$101	190%
Asuris Indiv And Family	$106	199%
Asuris Nw Health-All Other Plans	$106	199%

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 $84.
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 East Adams Rural 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.