Blood antibody screen
Facility: Kansas Heart Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $10
- Cash Discount Price: $32
- vs. Medicare Baseline: 0.19x 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 |
|---|---|---|
| Aetna | $1 - $9 | 2% |
| Wppa - All Plans | $6 - $35 | 11% |
| Tricare | $9 | 17% |
| Medicaid / KanCare | $10 | 19% |
| Humana | $10 | 19% |
| Celtic Mcr Adv | $10 | 19% |
| UnitedHealthcare | $10 | 19% |
| Multiplan - All Plans | $13 - $79 | 24% |
| Blue Cross Blue Shield | $14 | 26% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT 86850) at Kansas Heart Hospital in Wichita, KS, the facility's cash median price of $32.00 is notably lower than the state average, which sits at $53.24 according to Medicare benchmarks. While the hospital's negotiated rates for commercial payers range from $10.00 to $35.00, patients should be aware that these insurance rates often include administrative overhead and may exceed the cash price. If you have a high-deductible plan, paying the cash price of $32.00 upfront could result in significant savings compared to the negotiated rates your insurer might apply, especially if your deductible has not yet been met. It is advisable to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available, as paying in full before or shortly after the service can sometimes reduce the final amount owed.
The facility's pricing structure reflects a proprietary ownership model with nine different payers, including Medicaid/KanCare, Tricare, and various commercial plans like Aetna and UnitedHealthcare. While the median negotiated rate across these plans is $24.00, the gross chargemaster price listed is $51.00, highlighting the substantial difference between the billed amount and what is actually paid. To avoid unexpected costs, patients should request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. By comparing the facility's rates directly to the Medicare amount and seeking a detailed breakdown of charges, you can ensure you are not overpaying for this essential laboratory service.