CMS Price Transparency Data

Blood antibody screen

Facility: Mon Health Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $199
  • Cash Discount Price: $135
  • vs. Medicare Baseline: 3.74x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mon Health Medical Center is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.74x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$135

Average discount available for prompt cash payment at this facility.

Insurance Median
$199

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: $135 (254%)
Insurance Median: $199 (374%)
Cash: $135 (254% of Medicare)
Ins. Median: $199 (374% 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 374% of the Medicare baseline (a markup of 274%). 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
Unison_Plan $8 15%
Gateway_Health_Plan $9 17%
Aetna $16 - $50 30%
Zelis_Other_Plan $43 81%
Blue Cross Blue Shield $50 - $252 94%
Health_South_Mountain_View_Plan $50 94%
Humana $50 - $244 94%
Medicare (plans) $50 94%
Paramount_Elite_Plan $50 94%
Uhc_Va_Plan $50 94%
Zelis_Group_Health_Plan $50 94%
The_Health_Plan_Peia_Plan $51 96%
Seven_Corners_Plan $101 190%
Maryland_Physicians_Care_Plan $189 355%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $216 406%
The_Health_Plan_Plan $233 438%
Acpn_Plan $244 458%
Cigna $244 458%
Mon_County_Commission_Plan $244 458%
Uhc_Plan $244 458%
Health_Payors_Organization_Plan $249 468%
Uhc_Options_Ppo_Plan $252 473%
Multiplan_Phcs_Plan $257 483%
Mutual_Of_Omaha_Plan $257 483%
Geha_Plan $262 492%
Three_Rivers_Plan $262 492%
Uhc_Onenet_Ppo_Plan $262 492%
Upmc__Plan $262 492%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals