CMS Price Transparency Data

Blood antibody screen

Facility: Margaretville Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $86
Cash Discount Price: $196
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Margaretville Memorial Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.62x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$196

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $196 (368%)

Insurance Median: $86 (162%)

Cash: $196 (368% of Medicare)

Ins. Median: $86 (162% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $120	13%
UnitedHealthcare	$15 - $86	28%
Oxford	$15	28%
Aetna	$26 - $127	49%
Mvp	$41	77%
Mvp Hmo/Ppo	$49	92%
Mvp Gold (McR)	$86	162%
Medicare (plans)	$86 - $129	162%
Hamaspik (McR)	$86	162%
Affinity By Molina McR	$91	171%
Cdphp	$95	178%
Emblem Ghi/Hip Ppo/Cbp	$122	229%
Mvp Exchange	$127	239%
Emblem Select Care (Exchange)	$133	250%
Oxford Exchange	$137	257%
Magnacare Standard	$137	257%
Todays Options	$142	267%
Emblem Ghi/Hip Hmo/Epo/Pos	$157	295%
Multiplan	$161	302%
First Health	$176	331%
Magnacare Preferred	$774	1454%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $196.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Margaretville Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.