Blood antibody screen
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $51
- Cash Discount Price: $107
- vs. Medicare Baseline: 0.96x 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 | $3 - $153 | 6% |
| United Medical Resources Contracted [320454] | $3 - $27 | 6% |
| Medicaid / KanCare | $5 - $51 | 9% |
| Aetna | $8 - $51 | 15% |
| Blue Cross Blue Shield | $8 - $51 | 15% |
| First Health Contracted [320128] | $8 | 15% |
| Humana | $9 - $52 | 17% |
| Medica Contracted [320239] | $9 | 17% |
| Provider Partners Health Plans Contracted [320450] | $11 | 21% |
| Cigna | $22 - $51 | 41% |
| Point C Contracted [320238] | $27 - $124 | 51% |
| Healthscope Contracted [320182] | $27 - $124 | 51% |
| Insurance System Inc Contracted [320465] | $27 | 51% |
| Benefit Management Contracted [320052] | $27 | 51% |
| Health Systems Inc Contracted [320174] | $27 | 51% |
| Halo Hcr Inc Hospice Contracted [320432] | $51 | 96% |
| Medicare (plans) | $51 | 96% |
| Kindful Hospice Contracted [320434] | $51 | 96% |
| Cherokee Nation Health Serv Contracted [320066] | $51 | 96% |
| Mercy Hospice Okc [20252] | $51 | 96% |
| Kindful Hospice [20434] | $51 | 96% |
| Qual Choice Contracted [320325] | $51 | 96% |
| Elara Caring Aspire Hospice [20433] | $51 | 96% |
| Cross Timbers Hospice [20098] | $51 | 96% |
| Halo Hcr Inc Hospice [20432] | $51 | 96% |
| Medical Associates Health Contracted [320444] | $51 | 96% |
| Mercy Mgd Behavioral Health Contracted [320259] | $51 | 96% |
| Globalhealth Contracted [320145] | $51 | 96% |
| Tricare | $51 | 96% |
| Pace Of The Ozarks Contracted [320518] | $51 | 96% |
| Dept Of Veteran Affairs Contracted [320106] | $52 | 98% |
| Centivo Contracted [320505] | $52 | 98% |
| Mercy Benefit Admin Contracted [320251] | $54 - $116 | 101% |
| Show-Me Health Administrators Contracted [320483] | $54 | 101% |
| Providrs Care Network Contracted [320484] | $99 | 186% |
| Auxiant Contracted [320462] | $116 - $124 | 218% |
| Imagine 360 Contracted [320494] | $116 | 218% |
| Yuzu Health Contracted [320521] | $116 | 218% |
| Aither Health Contracted [320449] | $116 | 218% |
| Edison Health Solutions Contracted [320502] | $116 | 218% |
| Ebms Contracted [320493] | $116 | 218% |
| American Healthcare Alliance Contracted [320020] | $116 | 218% |
| Reflect Health Contracted [320492] | $116 | 218% |
| Federal Medical Center Contracted [320127] | $124 | 233% |
| Healthlink Contracted [320179] | $124 | 233% |
| Preferred Health Plan Contracted [320522] | $124 | 233% |
| Compcare Of The Ozarks Contracted [320437] | $130 | 244% |
| Workers Comp [20426] | $132 | 248% |
| Private Health Care Systems Contracted [320320] | $153 | 287% |
| Multiplan [20270] | $157 | 295% |
| Multiplan Contracted [320270] | $157 | 295% |
Consumer Guidance & Cost Commentary
For the "Blood antibody screen" procedure at Mercy Specialty Hospital Southeast Kansas, the facility's cash price of $107.00 is significantly lower than the gross charge of $165.00 and the median negotiated rate of $51.00 reported across 51 payers. While many commercial insurers negotiate rates ranging from $3 to $153, the cash price offers a potential savings for patients with high-deductible plans or those without insurance, as paying upfront can sometimes be cheaper than the insurance allowed amount. Patients should verify if their specific plan has a lower negotiated rate before scheduling, but the cash price remains a strong baseline for self-pay.
To maximize savings, patients should inquire about "prompt-pay" discounts, which are fee reductions typically offered for upfront payment within 30 days, effectively bypassing the administrative costs associated with insurance claims. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should review their itemized bills to ensure no unexpected charges exist. Comparing the facility's cash rate to the Medicare benchmark of $53.24 reveals that the cash price is higher than the federal baseline, suggesting that while the facility charges more than Medicare, the negotiated rates from major payers often fall below the gross charge, making the cash option a viable strategy for cost control.