What is the standard insurance baseline for CPT 86328?

The standard insurance baseline reimbursement rate is $44.37. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Test for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 Covid-19 Antibody

CPT 86328Medical Service

Test for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 Covid-19 Antibody

Q: What do doctors typically charge for Test for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 Covid-19 Antibody?

The nationwide median physician charge for Test for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 Covid-19 Antibody (CPT 86328) is $80.00. Doctor billed charges vary based on geographic region, setting, and overhead.

Test for detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody, qualitative or semiquantitative. Clinical pricing breakdown and utilization metrics across 119 practicing doctors nationwide.

$80.00

Peer Median Charge

Gross billed rate

$44.37

Standard Baseline

Customary allowable

1.8x

National Markup

Charge vs baseline

119

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $80.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $44.37 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 86328 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"