Blood antibody screen
Facility: Via Christi Hospital Wichita St Teresa, Inc
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $50
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.94x 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 |
|---|---|---|
| Smarthealth | $7 - $69 | 13% |
| Aetna | $31 | 58% |
| Via Christi Research | $49 | 92% |
| Medicare (plans) | $49 - $50 | 92% |
| Vc Hope | $49 | 92% |
| Va | $49 | 92% |
| Saint Lukes Health Systems | $49 | 92% |
| Humana | $49 | 92% |
| Blue Cross Blue Shield | $50 | 94% |
| UnitedHealthcare | $50 - $138 | 94% |
| Corizon | $62 | 116% |
| Medicaid / KanCare | $84 | 158% |
Consumer Guidance & Cost Commentary
This report details the pricing for CPT code 86850, a blood antibody screen, at Via Christi Hospital Wichita St Teresa, Inc. The facility's negotiated rates range from $7 to $138 across 12 different payers, with a median negotiated amount of $50.00. For comparison, the Medicare benchmark for this service is $53.24, and the state average for this procedure is $50.00. While commercial insurance contracts often result in higher costs due to administrative overhead and claim processing fees, patients with high-deductible plans may find that paying the cash price directly is more cost-effective, as the cash rate can sometimes be lower than the insurance negotiated rate. It is important to note that cash prices are not explicitly listed in this dataset, so patients should contact the hospital directly to confirm current self-pay or prompt-pay discounts before scheduling.
Patients should be aware of potential billing complexities, such as balance billing if a specific lab test is performed by an out-of-network provider, which could lead to unexpected charges beyond what the insurance allows. Additionally, summary bills that only show broad categories like "Laboratory" may obscure individual line items; consumers are advised to request a full itemized bill to verify that all services rendered are accurately coded and that no unbundled charges or services not delivered are included. To ensure the most accurate pricing, patients should verify their specific plan's deductible status before using insurance, as paying out-of-pocket before meeting a deductible can sometimes result in higher out-of-pocket costs than expected.