CMS Price Transparency Data
Blood antibody screen
Facility: Clovis Community Medical Center
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $67
- Cash Discount Price: $168
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Clovis Community Medical Center is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.26x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$168
Average discount available for prompt cash payment at this facility.
Insurance Median
$67
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: $168 (316%)
Insurance Median: $67 (126%)
Cash: $168 (316% of Medicare)
Ins. Median: $67 (126% 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medi-Cal Health Plan of San Mateo | $3 | 6% |
| Santa Clara Family Health Plan - Premier Health | $3 | 6% |
| Generic Ccs Other Counties | $3 | 6% |
| Ccs Tulare | $3 | 6% |
| Fresno County Funded Specialty Care | $3 | 6% |
| Medi-Cal Molina | $3 | 6% |
| Ccs Kern | $3 | 6% |
| Medi-Cal Contra Costa Health Plan | $3 | 6% |
| Ccs Fresno | $3 | 6% |
| Generic Care Out of County | $3 | 6% |
| Genetically Handicapped Person | $3 | 6% |
| Ccs Stanislaus | $3 | 6% |
| Medi-Cal La Care Health | $3 | 6% |
| Blue Shield | $3 - $120 | 6% |
| Ccs Madera/Sacramento | $3 | 6% |
| Ccs Kings | $3 | 6% |
| Cal Caloptima | $3 | 6% |
| San Francisco Health Plan Medi-Cal | $3 | 6% |
| Medi-Cal California Health & Wellness Plan | $3 | 6% |
| Santa Clara Family Health Plan - Valley Health | $3 | 6% |
| Medi-Cal Blue Shield Promise Health | $3 | 6% |
| Medi-Cal Partnership Health Plan of Ca | $3 | 6% |
| Blue Cross Blue Shield | $3 - $134 | 6% |
| Gold Coast Medi-Cal | $3 | 6% |
| Ccs Merced | $3 | 6% |
| Medi-Cal Alameda Alliance for Health | $3 | 6% |
| Medi-Cal Kern Family Health | $3 | 6% |
| Medi-Cal Inland Empire Health | $3 | 6% |
| Chdp | $3 | 6% |
| Ccs Mariposa | $3 | 6% |
| Medi-Cal Community Health Group | $3 | 6% |
| Medi-Cal Cencal Health | $3 | 6% |
| Adventist -McL Calviva Sub Cap | $4 | 8% |
| Sante | $4 - $67 | 8% |
| Sequoia Pace | $4 | 8% |
| Health Plan of San Joaquin | $4 | 8% |
| Healthnet | $5 - $123 | 9% |
| Central Valley Medical Providers | $50 - $147 | 94% |
| Community Care | $51 - $54 | 96% |
| Kaiser | $53 | 100% |
| Aetna | $53 - $105 | 100% |
| Sequoia Pace - Peak Tpa | $67 | 126% |
| Us Marshal | $67 | 126% |
| Railroad Part A | $67 | 126% |
| Scan Health Plan | $67 | 126% |
| Meritage Brand New Day | $67 | 126% |
| Victims of Crime | $67 | 126% |
| Sante-Blue Shield/Sante | $67 | 126% |
| Healthnet HMO - Sante | $67 | 126% |
| Healthnet Sante Dual Risk | $67 | 126% |
| Blue Shield 65 Plus HMO First Choice | $67 | 126% |
| Hartford Life Supplement | $67 | 126% |
| Todays Pyramid | $67 | 126% |
| Meritage Blue Shield 65 Plus | $67 | 126% |
| Sante-Sub Cap Ma Brand New Day | $67 | 126% |
| Healthnet HMO - Dhmso | $67 | 126% |
| Blue Shield Hmo-Cvmp/Medpro | $67 | 126% |
| Blue Shield Promise - Imperial | $67 | 126% |
| Healthnet Sante - Sub Cap Dual Risk | $67 | 126% |
| Humana | $67 - $179 | 126% |
| Generic Victims of Crime | $67 | 126% |
| Blue Shield 65 Plus HMO Ehs | $67 | 126% |
| Blue Shield Saint Agnes | $67 | 126% |
| Wellcare | $67 | 126% |
| Blue Shield Sante | $67 | 126% |
| Generic Bscphp | $67 | 126% |
| Care1St HMO - Ehs | $67 | 126% |
| Healthnet HMO - La Salle | $67 | 126% |
| Cigna | $67 - $130 | 126% |
| Generic | $67 | 126% |
| Sante Sub Cap-Blue Shield/Sante | $67 | 126% |
| Sante Sub Cap Healthnet Seniority | $67 | 126% |
| Railroad Part B | $67 | 126% |
| Bscphp HMO - First Choice | $67 | 126% |
| Meritage Healthnet HMO | $67 | 126% |
| Medi-Cal Innovative Integrated Health | $67 | 126% |
| Bscphp - Dhmso | $67 | 126% |
| Railroad Part A & B | $67 | 126% |
| Bscphp - First Choice | $67 | 126% |
| Advantek Table Mountain Rancheria Tribal Member | $67 | 126% |
| Medicare (plans) | $67 | 126% |
| Brand New Day | $67 | 126% |
| Healthnet HMO - Cvmp/Medpro | $67 | 126% |
| Healthnet Sante | $67 | 126% |
| Gemcare HMO | $67 | 126% |
| UnitedHealthcare | $67 - $110 | 126% |
| Cares Act Provider Relief Fund | $67 | 126% |
| Sante-Healthnet Seniority | $67 | 126% |
| Alignment Health Plan | $74 | 139% |
| Champion Health Plan of California Ma | $74 | 139% |
| Innovative Integrated Health Community Plans HMO | $74 | 139% |
| Imperial Health Plan HMO | $77 | 145% |
| Employer 90/40 | $80 - $84 | 150% |
| Correctcare Integrated Health | $87 | 163% |
| Central Ca Indian Health | $110 - $116 | 207% |
| Nx Health Network PPO | $110 - $116 | 207% |
| Coalinga State Hospital | $134 | 252% |
| Healthsmart | $136 - $168 | 255% |
| Naphcare Inc-Mendota | $144 | 270% |
| Network By Design | $150 - $158 | 282% |
| Coventry Health Care (First Health Network) | $150 - $158 | 282% |
| PHCS | $170 - $179 | 319% |
| Generic Multiplan | $170 - $179 | 319% |
| Well Path (Cfmg) | $220 - $231 | 413% |