Blood antibody screen
Facility: Saint John Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $49
- Cash Discount Price: $49
- vs. Medicare Baseline: 0.92x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthy Blue | $8 - $52 | 15% |
| Celtic | $8 - $79 | 15% |
| Medicaid / KanCare | $8 | 15% |
| UnitedHealthcare | $8 - $69 | 15% |
| Comp Alliance Workers Comp | $16 | 30% |
| Aetna | $17 - $49 | 32% |
| Oha Networks | $17 | 32% |
| Worker Compensation | $18 | 34% |
| Blue Cross Blue Shield | $43 - $91 | 81% |
| Cigna | $49 | 92% |
| Midland Care Connection | $49 | 92% |
| Tricare | $49 | 92% |
| Medicare (plans) | $49 | 92% |
| Kansas Superior Select | $50 | 94% |
| Corizon | $69 | 130% |
| Employer Direct Healthcare | $69 | 130% |
| Well Path | $69 | 130% |
| Centurion | $74 | 139% |
| Naphcare | $76 | 143% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Saint John Hospital in Leavenworth, KS, lists a gross charge of $165.00. While the facility's cash median rate is $49.00 and the median negotiated rate for in-network payers is also $49.00, these figures are significantly lower than the Medicare benchmark of $53.24. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; however, in this specific case, the cash and negotiated rates align closely with the Medicare baseline, which serves as the scientifically validated cost standard for evaluating hospital pricing markups. Patients should be aware that comparing discounts to the inflated chargemaster list can be misleading, as the true value is measured against the Medicare rate rather than the facility's maximum list price.
Insurance coverage varies widely across the 19 payers listed for this service, with allowed amounts ranging from $8.00 for Healthy Blue to $91.00 for Blue Cross Blue Shield. Because commercial rates can sometimes be higher than cash prices, individuals with high-deductible plans may find it financially advantageous to pay the cash rate of $49.00 directly, provided they have not yet met their deductible. To secure the best possible price, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer an additional reduction for upfront payment. Furthermore, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status and request an itemized bill to ensure no unexpected charges are applied for