Blood antibody screen
Facility: Stormont Vail Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $48
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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 | $8 | 15% |
| Ambetter / Centene | $8 | 15% |
| Blue Cross Blue Shield | $9 - $91 | 17% |
| Humana | $48 - $49 | 90% |
| Aetna | $48 - $49 | 90% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Stormont Vail Hospital in Topeka, KS, has a median negotiated rate of $49.00, which aligns closely with the state average of $48.00. This rate is slightly lower than the Medicare benchmark of $53.24, indicating a pricing structure that is fair relative to federal cost baselines. While the facility's chargemaster gross charge is listed at $178.00, commercial payers like UnitedHealthcare and Ambetter / Centene have negotiated rates starting at $8.00, whereas Blue Cross Blue Shield rates range significantly higher, from $9.00 to $91.00 depending on the specific plan. Patients should be aware that cash-pay options are not explicitly listed in this report, but asking for self-pay or prompt-pay discounts before scheduling can often result in substantial savings, especially if your insurance negotiated rate exceeds the cash price.
It is important to distinguish between the hospital's gross charges and the actual amounts you will pay. The gross charge of $178.00 represents the maximum list price and is not what you will be billed; instead, your payment will depend on your insurance plan's negotiated rate or your out-of-pocket responsibility. Since the Medicare rate of $53.24 serves as a scientifically validated baseline for the true cost of care, any commercial rate significantly higher than this could indicate a markup, though the facility's negotiated rate here remains competitive. If you have a high-deductible plan, you may face the full negotiated amount of $49.00 until your deductible is met, so verifying