Blood antibody screen
Facility: Lmh
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $67
- Cash Discount Price: $45
- vs. Medicare Baseline: 1.26x 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 - $92 | 15% |
| Blue Cross Blue Shield | $8 - $155 | 15% |
| Aetna | $11 - $199 | 21% |
| Humana | $52 | 98% |
| Medicare (plans) | $52 | 98% |
| Haskell Indian Health Services | $52 | 98% |
| Cigna | $52 - $160 | 98% |
| Allwell | $54 | 101% |
| Ambetter / Centene | $81 | 152% |
| Non Contracted | $94 - $192 | 177% |
| First Health | $110 - $223 | 207% |
Consumer Guidance & Cost Commentary
For the CPT code 86850 (Blood antibody screen), the facility in Lawrence, KS, lists a gross charge of $179.00, which is significantly higher than the state average. However, patients can often secure lower rates by paying cash directly, with a cash median of $45.00. This cash price is notably lower than the facility's negotiated rates, which range from $8 to $223 depending on the insurance carrier. While commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates starting at $8, these amounts may still exceed the cash price for patients with high-deductible plans. It is important to note that commercial negotiated rates often include administrative overhead and do not reflect the true cost of care, making direct comparison with the Medicare rate of $53.24 a more accurate benchmark for understanding fair pricing.
To minimize out-of-pocket costs, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as hospitals frequently offer fee reductions of 20% to 50% for upfront payments. These discounts bypass the costly insurance claims process, allowing the facility to provide immediate liquidity while avoiding administrative fees that inflate commercial rates. Additionally, patients should avoid paying surprise balance bills immediately; under the No Surprises Act, balance billing for emergency services or non-emergency services at in-network facilities is generally prohibited, and patients should request a formal itemized audit if they receive unexpected charges. By comparing the facility's cash median of $45.00 against the Medicare benchmark of $53.24, patients can see that paying cash or utilizing prompt-pay options often results in a price closer to the true