CMS Price Transparency Data

Blood antibody screen

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $87
Cash Discount Price: $90
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at University of Wi Hospitals & Clinics Authority is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.63x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $90 (169%)

Insurance Median: $87 (163%)

Cash: $90 (169% of Medicare)

Ins. Median: $87 (163% 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	$49 - $142	92%
Aetna	$53 - $120	100%
Humana	$53	100%
Medicare (plans)	$53 - $54	100%
UnitedHealthcare	$53 - $94	100%
Alliance_Premier_Network	$72	135%
Mercycare	$74	139%
Triology	$76 - $92	143%
Security_Health_Plan	$81 - $95	152%
Employer'S_Coalition_On_Health	$82 - $116	154%
Alliance	$84	158%
Hfn	$86 - $116	162%
United_Healthcare	$86 - $127	162%
Beloit_Health_System	$87	163%
Aspirus_Health_Plan	$88	165%
Cigna	$90	169%
Health_Partners_Insurance	$92	173%
Health_Payment_Systems	$92	173%
Dean_Health_Plan	$96	180%
Medical_Associates	$99	186%
Wps	$104 - $114	195%
Employers_Healthcare_Coalition_Of_Wi	$105	197%
Aspirus_Network_Inc	$116	218%
Chorus_Community	$120	225%
Ghc_Eau_Claire_Health_Plan	$120	225%
Multiplan	$120 - $138	225%
Sheybogan_Employers_Health_Network	$120	225%
Coventry	$128	240%
Dean_Care	$128	240%
Healthsmart	$132	248%

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 $90.
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 University of Wi Hospitals & Clinics Authority 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.