CMS Price Transparency Data

Blood antibody screen

Facility: Froedtert Memorial Lutheran Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $137
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 2.57x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Froedtert Memorial Lutheran Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.57x the Medicare baseline. Located in 9200 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$137

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: $114 (214%)
Insurance Median: $137 (257%)
Cash: $114 (214% of Medicare)
Ins. Median: $137 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Network Health Plan $10 - $54 19%
Sheboygan Employers Health Network $12 23%
UnitedHealthcare $12 - $54 23%
Centivo $41 - $142 77%
Medical College Of Wisconsin $46 - $142 86%
Blue Cross Blue Shield $49 - $54 92%
Chorus Community Health Plan $54 - $167 101%
Community Care $54 101%
Health Partners $54 - $266 101%
Humana $54 101%
Icare $54 101%
Molina $54 101%
Priority Health $54 101%
Quartz $54 101%
Security Health Plan $54 - $337 101%
Upper Peninsula Health Plan $54 101%
Aetna $55 - $279 103%
Froedtert South $55 - $172 103%
Wellcare $55 103%
Care Wisconsin/Mychoice $56 105%
Wisconsin Physician Services Statewide Alliance $87 - $270 163%
Trilogy $90 - $279 169%
Health Payment Systems $91 - $282 171%
Cigna $108 - $335 203%
Dean Health Plan $110 - $343 207%
Group Health Cooperative $110 - $343 207%
Healtheos $110 - $343 207%
Multiplan/Private Healthcare Systems $110 - $343 207%
Healthsmart $115 - $356 216%
Wisconsin Physician Services $117 - $365 220%
First Health Network $119 - $371 224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9200 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals