CMS Price Transparency Data

Blood antibody screen

Facility: St Anthony Community Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $68
  • Cash Discount Price: $923
  • vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at St Anthony Community Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $923. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.28x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$923

Average discount available for prompt cash payment at this facility.

Insurance Median
$68

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: $923 (1734%)
Insurance Median: $68 (128%)
Cash: $923 (1734% of Medicare)
Ins. Median: $68 (128% 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.

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
Self-Pay $7 13%
Blue Cross Blue Shield $7 - $369 13%
Aetna $17 - $19 32%
Cigna $21 - $646 39%
Emblem Select Care (Exchange) $25 47%
Emblem Ghi/Hip PPO $29 54%
Magnacare Preferred $39 73%
Mvp Exchange $42 79%
Mvp Gold (McR) $65 122%
Hamaspik (McR) $65 122%
Medicare (plans) $65 - $69 122%
Tricare $65 122%
Affinity By Molina McR $68 128%
Mvp Hmo/Ppo $82 154%
Geisinger Health Commercial/Exchange $214 402%
Self-Pay - Cc 30% $277 520%
Self-Pay - Cc 50% $462 868%
Cdphp $462 868%
Oxford Exchange $462 868%
UnitedHealthcare $646 1213%
Oxford Commercial $646 1213%
Multiplan $692 1300%
PHCS $692 1300%
Emblem Ghi/Hip Hmo/Epo/Pos $738 1386%
First Health $785 1474%
Mvp $9,139 - $10,772 17166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals