CMS Price Transparency Data

Blood antibody screen

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $169
  • Cash Discount Price: $182
  • vs. Medicare Baseline: 3.17x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Rehabilitation Hospital of Wisconsin is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $182. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.17x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$182

Average discount available for prompt cash payment at this facility.

Insurance Median
$169

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: $182 (342%)
Insurance Median: $169 (317%)
Cash: $182 (342% of Medicare)
Ins. Median: $169 (317% 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 317% of the Medicare baseline (a markup of 217%). 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
Alliance Ppo $29 - $144 54%
Dean Ppo Hmo/Pos $29 - $144 54%
Medica (Under Dean) $29 - $144 54%
UnitedHealthcare $30 - $209 56%
Trilogy Ppo $31 - $209 58%
Wps "Insurance" Ppo $31 - $153 58%
Hps Solutions Ppo $32 - $159 60%
Phcs Savility $32 - $157 60%
Aetna $33 - $209 62%
Health Eos Poc $34 - $167 64%
Coventry/First Health Ppo $35 - $171 66%
Hps (Other) $35 - $171 66%
Health Eos Multiplan $36 - $178 68%
Phcs / Multiplan $39 - $192 73%
All Savers $43 - $209 81%
Blue Cross Blue Shield $43 - $209 81%
Centivo Broad $43 - $209 81%
Centivo Intermediate/Median $43 - $209 81%
Centivo Narrow/Value $43 - $209 81%
Children'S Communty Health Plan(Cchp) $43 - $209 81%
Cigna $43 - $209 81%
Community Care, Inc $43 - $209 81%
Humana $43 - $209 81%
Icare Mcd $43 - $209 81%
Managed Health Services (Mhs) $43 - $209 81%
Medicaid / KanCare $43 - $209 81%
Medicare (plans) $43 - $209 81%
Molina (Fka Care Wisconsin) $43 - $209 81%
Network Health - Aca $43 - $209 81%
Network Health - Commercial $43 - $209 81%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $43 - $209 81%
Security Health Plan - Advocare $43 - $209 81%
Together With Cchp $43 - $209 81%
Unity Health Plan And Unity Quartz(Hmo/Pos) $43 - $209 81%
Va - Primary Only - Authorization Required $43 - $209 81%
Wellcare Mcr $43 - $209 81%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL