Blood antibody screen
Facility: St. Catherine Hospital - Garden City
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $65
- Cash Discount Price: $173
- vs. Medicare Baseline: 1.22x 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 |
|---|---|---|
| UnitedHealthcare | $9 - $65 | 17% |
| Humana | $10 | 19% |
| Innovage | $10 | 19% |
| Devoted Health | $10 | 19% |
| Medicare (plans) | $10 | 19% |
| Kaiser | $10 - $210 | 19% |
| Blue Cross Blue Shield | $10 - $108 | 19% |
| Aetna | $10 - $88 | 19% |
| Kansas Health | $10 | 19% |
| Cigna | $10 - $13 | 19% |
| Centura Employee Plan | $13 | 24% |
| United Colorado Doctor'S Plan | $15 | 28% |
| Direct To Employer | $17 - $305 | 32% |
| Wpaa | $74 | 139% |
| Christian Health Aid | $84 | 158% |
| Multiplan | $95 - $647 | 178% |
| Health Partners Of Kansas | $102 | 192% |
| Denver Health | $180 | 338% |
| Peak Health | $297 | 558% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, Blood antibody screen, St. Catherine Hospital - Garden City has a gross charge of $433.00, with a cash median of $173.00 and a median negotiated rate of $65.00. While the facility is a voluntary non-profit church-owned acute care hospital in Garden City, KS, the cash price of $173.00 is significantly higher than the state average of $38.00 for this service. However, for patients with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than relying on insurance, as the negotiated rate of $65.00 often exceeds the cash price due to administrative overheads. It is important to note that the facility's rating is 2, and patients should verify if their specific plan falls within the 19 identified payers, as rates vary widely; for instance, Kaiser's internal rate is noted as not a typical negotiated rate, while Multiplan's range extends up to $647.
Patients should be aware that commercial insurance rates are often inflated compared to the Medicare benchmark of $53.24, which serves as a scientifically validated cost baseline. The facility's gross charge of $433.00 represents a substantial markup over the Medicare amount, illustrating why comparing against the chargemaster list rather than the Medicare rate can be misleading. To minimize costs, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer fee reductions for upfront payment that bypass the costly insurance claims cycle. Additionally, if a patient receives an itemized bill, they should