Blood antibody screen
Facility: Pratt Regional Medical Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $43
- Cash Discount Price: $34
- vs. Medicare Baseline: 0.81x 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 |
|---|---|---|
| Christian Health Aid | $26 - $78 | 49% |
| UnitedHealthcare | $28 - $106 | 53% |
| Health Partners Of Kansas | $29 - $88 | 54% |
| Aetna | $31 - $94 | 58% |
| Choicecare | $34 - $104 | 64% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Pratt Regional Medical Center in Pratt, KS, lists a cash median price of $34.00, which is lower than the facility's gross charge of $49.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $28 to $106, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or by requesting a prompt-pay discount before scheduling. It is important to note that commercial negotiated rates frequently include administrative overhead and can be significantly higher than the cash rate, so verifying the self-pay or prompt-pay classification prior to service is essential to avoid unexpected costs.
This service is benchmarked against the Medicare rate of $53.24, which serves as a scientifically validated baseline for the true cost of care. The facility's cash price of $34.00 is approximately 64% of the Medicare amount, indicating a pricing structure that is below the federal benchmark. Although the data does not provide specific state or county average comparisons for this exact code, patients should be aware that balance billing can occur if they receive care from out-of-network providers, potentially resulting in bills for the difference between the provider's full charge and the insurance allowed amount. To protect against surprise billing, consumers should request an itemized bill to review all CPT codes and ensure no unbundled charges or services not rendered are included before finalizing payment.