CMS Price Transparency Data

Blood antibody screen

Facility: Childrens Hospital of Wisconsin

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $113
  • Cash Discount Price: $77
  • vs. Medicare Baseline: 2.12x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Childrens Hospital of Wisconsin is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.12x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$77

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $77 (145%)
Insurance Median: $113 (212%)
Cash: $77 (145% of Medicare)
Ins. Median: $113 (212% 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 212% of the Medicare baseline (a markup of 112%). 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
Chorus Community Health Plan $5 9%
My Choice Wisconsin $5 - $6 9%
UnitedHealthcare $5 - $112 9%
Blue Cross Blue Shield $6 - $140 11%
Managed Health Services $6 11%
Molina Healthcare Of Wisconsin $6 11%
Icare $7 13%
Froedtert Health $93 - $125 175%
Medical College Of Wisconsin $93 - $103 175%
Network Health Plan $95 - $105 178%
Aspirus Health Plan $100 - $111 188%
Common Ground Healthcare Cooperative $100 - $125 188%
Trilogy Health Solutions $100 - $125 188%
Wps Health Plan $101 - $133 190%
Advocate Aurora Healthcare $103 - $114 193%
Centivo $104 - $115 195%
Health Partners $104 - $130 195%
Employer Health Care Alliance Cooperative $105 - $116 197%
Dean Health Plan $107 - $118 201%
Group Health Cooperative Of Eau Claire $107 - $118 201%
Oan Llc $107 - $118 201%
Security Health Plan $111 - $122 208%
Health Payment Systems $113 - $125 212%
Praire States $113 - $125 212%
Quartz Health Insurance $113 - $125 212%
Sheboygan Employer'S Health Network $113 - $125 212%
Mayo Clinic Health Solutions $116 - $128 218%
Aetna $117 - $131 220%
Bellin Thedacare $120 - $133 225%
Cigna $120 - $133 225%
Group Health Cooperative Of South Central Wisconsin $120 - $133 225%
Prevea Health Network $120 - $133 225%
Multiplan $121 - $140 227%
Coventry Health Care $127 - $140 239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens