CMS Price Transparency Data
Blood antibody screen
Facility: Watsonville Community Hospital
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $540
- Cash Discount Price: $542
- vs. Medicare Baseline: 10.14x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Watsonville Community Hospital is $540. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $542. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 10.14x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$542
Average discount available for prompt cash payment at this facility.
Insurance Median
$540
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: $542 (1018%)
Insurance Median: $540 (1014%)
Cash: $542 (1018% of Medicare)
Ins. Median: $540 (1014% 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 1014% of the Medicare baseline (a markup of 914%). 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 |
|---|---|---|
| California Childrens Srvs | $4 | 8% |
| Medi-Cal/Eds | $4 | 8% |
| Ccs/Monterey County | $4 | 8% |
| Medi-Cal E.R. | $4 | 8% |
| Well Path | $4 - $903 | 8% |
| Healthy Families | $4 - $31 | 8% |
| Medicaid / KanCare | $4 | 8% |
| Alliance/Sccho | $4 | 8% |
| Blue Shield PPO | $10 - $31 | 19% |
| Kemper Group Workers Comp | $10 | 19% |
| Secure Horizons | $10 | 19% |
| Travelers Insurance | $10 - $903 | 19% |
| Secure Horizons Dign HMO | $10 - $181 | 19% |
| Tricare | $10 | 19% |
| Pinnacle Healthcare Uc | $10 | 19% |
| Fireman's Fund Work Comp | $10 | 19% |
| U.S. Dept. of Labor | $10 | 19% |
| Liberty Mutual Work Comp | $10 | 19% |
| Gallagher Bassett Svcs | $10 | 19% |
| Keenan & Assoc Work Comp | $10 | 19% |
| Ace-Usa | $10 | 19% |
| Alignment Health Plan | $10 | 19% |
| Republic Idemnity W/Comp | $10 | 19% |
| Hartford Workers' Comp | $10 | 19% |
| Workers Comp | $10 | 19% |
| Veterans Administration | $10 | 19% |
| Medicare (plans) | $10 | 19% |
| Health Net of California | $10 - $566 | 19% |
| UnitedHealthcare | $10 - $542 | 19% |
| Beta Healthcare Group | $10 | 19% |
| Crawford & Co | $10 | 19% |
| Nx Health Network | $10 | 19% |
| Miscellaneous Work Comp | $10 | 19% |
| Fleming & Associates | $10 | 19% |
| Western Growers Work Comp | $10 | 19% |
| Ufcw/Valley Clerks | $31 | 58% |
| United Agriculture | $31 | 58% |
| Bs Employee | $31 | 58% |
| Carpenters H&W Trust | $72 - $804 | 135% |
| Claims Management Wc | $72 - $804 | 135% |
| Monterey Bay Pub Emp Trst | $72 - $804 | 135% |
| Robert Kennedy/Ccn | $72 - $804 | 135% |
| Pinnacle Claims Tpa/Bc | $72 - $804 | 135% |
| Laborers Health & Welfare | $72 - $804 | 135% |
| Sheet Metal Workers | $72 - $804 | 135% |
| Western Growers Trust/Bc | $72 - $804 | 135% |
| Blue Cross Blue Shield | $72 - $804 | 135% |
| Delta Health Systems | $72 - $804 | 135% |
| Teamsters Benefit Trust | $72 - $804 | 135% |
| City of Wats/Pinnacle Clm | $72 - $804 | 135% |
| State Compensation Fund | $72 - $804 | 135% |
| Operating Engineers | $72 - $804 | 135% |
| Calif Ironworkers Field | $72 - $804 | 135% |
| Victim Compensation Plan | $162 - $903 | 304% |
| Medicruz | $162 | 304% |
| Blue Shield HMO | $181 | 340% |
| Pacificare HMO | $181 - $542 | 340% |
| Cigna | $181 - $632 | 340% |
| Health Net Pmg HMO | $181 - $566 | 340% |
| Aetna | $181 - $740 | 340% |
| Great-West/Phcs | $181 - $632 | 340% |
| Western Health Advantage | $451 | 847% |
| Self Pay | $542 | 1018% |
| Health Net Smartcare Netw | $542 | 1018% |
| Pacificare PPO | $542 | 1018% |
| Health Net Canopycare HMO | $566 | 1063% |
| Health Net Blue and Gold | $566 | 1063% |
| Adventist Risk Management | $632 - $722 | 1187% |
| Transwestern | $632 - $722 | 1187% |
| Geha (Ccn) | $632 - $722 | 1187% |
| First Health | $632 - $722 | 1187% |
| Multiplan Inc PPO | $704 | 1322% |
| Private Healthcare System | $704 | 1322% |
| Coastal Healthcare Admin | $767 - $812 | 1441% |
| Salinas Valley Mem Hops | $767 | 1441% |
| Miscellaneous Insurance | $903 | 1696% |
| Zenith National Ins | $903 | 1696% |
| Farmers Insurance | $903 | 1696% |
| Humana | $903 | 1696% |
| Allstate | $903 | 1696% |
| Wholesale Beer Distributo | $903 | 1696% |
| Bankers Life & Casualty | $903 | 1696% |
| North Calif Bakery Driver | $903 | 1696% |
| State Farm Ins | $903 | 1696% |
| Apwu Health Plan | $903 | 1696% |
| Prucare Pmg HMO | $903 | 1696% |
| Sutter Health Plus | $903 | 1696% |
| Physicians Mutual | $903 | 1696% |
| United Administrative | $903 | 1696% |
| Aarp | $903 | 1696% |
| Aaa | $903 | 1696% |
| Miscellaneous Auto | $903 | 1696% |
| Prucare Pmg POS | $903 | 1696% |