Blood antibody screen
Facility: Providence Medical Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $49
- Cash Discount Price: $49
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| Medicaid / KanCare | $8 | 15% |
| UnitedHealthcare | $8 - $69 | 15% |
| Healthy Blue | $8 - $52 | 15% |
| Celtic | $8 - $79 | 15% |
| Aetna | $10 - $49 | 19% |
| Comp Alliance - Fka Compresults Worker Compensation | $16 | 30% |
| Oha Networks | $17 | 32% |
| Worker Compensation | $18 | 34% |
| Blue Cross Blue Shield | $23 - $91 | 43% |
| Tricare | $49 | 92% |
| Cigna | $49 | 92% |
| Medicare (plans) | $49 | 92% |
| Midland Care Connection | $49 | 92% |
| Kansas Superior Select | $52 | 98% |
| Corizon | $64 | 120% |
| Employer Direct Healthcare | $69 | 130% |
| Well Path Prison | $69 | 130% |
| Centurion | $74 | 139% |
| Naphcare | $76 | 143% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT 86850) at Providence Medical Center in Kansas City, KS, the facility's cash median rate of $49.00 aligns exactly with the state average for this service. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $8 to $91, these amounts often exceed the cash price due to administrative overhead and contract structures. For patients with high-deductible plans or those without insurance, paying the cash rate of $49.00 may be more cost-effective than relying on insurance, which can result in higher out-of-pocket costs if the deductible has not yet been met. It is advisable to confirm with the hospital's billing department regarding "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
The facility's Medicare benchmark rate of $53.24 serves as a scientifically validated baseline for evaluating pricing fairness, representing the true cost of care rather than the inflated chargemaster list price. Although the facility's negotiated rates average $49.00, which is slightly below the Medicare benchmark, patients should be aware that commercial rates can sometimes fluctuate based on network tiering and payer contracts. To ensure transparency, consumers should request an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. By comparing the facility's rates directly to the Medicare benchmark and seeking prompt-pay incentives, patients can make informed decisions that minimize unexpected financial burdens.