Blood antibody screen
Facility: Mcpherson Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $121
- Cash Discount Price: $107
- vs. Medicare Baseline: 2.27x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 227% of the Medicare baseline (a markup of 127%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Tricare | $9 | 17% |
| Wellcare Mcr Adv - All Plans | $10 | 19% |
| Va Ccn - All Plans | $10 | 19% |
| Blue Cross Blue Shield | $10 | 19% |
| Humana | $10 | 19% |
| Healthy Blue Mcr Adv | $10 | 19% |
| UnitedHealthcare | $10 - $159 | 19% |
| Ambetter / Centene | $11 | 21% |
| Wppa - All Plans | $90 - $111 | 169% |
| Medical Associates - All Plans | $97 - $119 | 182% |
| Central Plains - All Plans | $97 - $119 | 182% |
| Christian Health Aid - All Plans | $103 - $127 | 193% |
| Aetna | $106 - $159 | 199% |
| Multiplan - All Plans | $116 - $143 | 218% |
| Health Partners - All Plans | $123 - $151 | 231% |
| Cigna | $123 - $151 | 231% |
| First Health - All Plans | $123 - $151 | 231% |
| Medicaid / KanCare | $129 - $159 | 242% |
| Health Blue Mcaid - All Other Plans | $132 - $162 | 248% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, representing a blood antibody screen at McPherson Hospital in McPherson, Kansas, the facility's cash median rate is $107.00, while the median negotiated rate across 19 payers is $121.00. This cash price is notably lower than the facility's gross charge of $144.00 and aligns closely with the state average, as the Medicare benchmark for this service is $53.24. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as the negotiated rates paid by insurers often exceed the cash amount. To secure the lowest possible cost, patients should inquire about self-pay or prompt-pay discounts before scheduling, which can further reduce the bill by offering immediate liquidity incentives that bypass standard claims processing fees.
While the facility is an in-network location for most major insurers including Tricare, Wellcare, and UnitedHealthcare, the wide variation in negotiated rates—ranging from $9 to $159 across different plans—highlights the importance of verifying your specific plan's allowed amount prior to receiving care. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to ensure that ancillary services, such as lab draws, are also covered under your plan to avoid unexpected charges. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, allowing them to review specific CPT codes and identify any unbundled charges or services not rendered. Always confirm your deductible status and ask for a