CMS Price Transparency Data

Blood antibody screen

Facility: Black River Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $161
Cash Discount Price: $185
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Black River Memorial Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.02x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$185

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

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: $185 (347%)

Insurance Median: $161 (302%)

Cash: $185 (347% of Medicare)

Ins. Median: $161 (302% 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 302% of the Medicare baseline (a markup of 202%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$4 - $124	8%
Group Health Cooperative Of Eau Claire	$5 - $236	9%
My Choice Wisconsin, Inc.	$5 - $124	9%
Quartz Health Solutions, Inc	$5 - $221	9%
UnitedHealthcare	$5 - $229	9%
Humana	$86 - $226	162%
Security Health Plan	$86 - $227	162%
Corvel	$103 - $148	193%
The Alliance	$144 - $233	270%
Triology Health Solutions	$152 - $231	285%
Medica	$158 - $227	297%
Association Benefits Solution	$161 - $231	302%
Family Health Center Of Marshfield	$161 - $231	302%
First Health Group Corporation	$161 - $231	302%
Provider Network Of America	$161 - $231	302%
Cigna	$164 - $236	308%
Cofinity	$164 - $236	308%
Coventry Health Care	$164 - $236	308%
Custom Benefit Administrators	$164 - $236	308%
Healthpartners, Inc.	$164 - $236	308%
Multiplan	$164 - $241	308%
Wisconsin Physicians Service Insurance Corp	$164 - $236	308%
Chorus	$166 - $238	312%

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 $185.
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 Black River Memorial 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.