Blood antibody screen
Facility: Lane County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $50
- Cash Discount Price: $50
- 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 |
|---|---|---|
| UnitedHealthcare | $27 - $125 | 51% |
| Aetna | $27 - $119 | 51% |
| Healthy Blue Mcr Adv - All Other Plans | $30 - $125 | 56% |
| Healthy Blue Mcaid | $30 - $125 | 56% |
| Medicaid / KanCare | $30 - $138 | 56% |
| Wppa Providers-All Plans | $45 - $188 | 85% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, representing a blood antibody screen at Lane County Hospital in Dighton, KS, the facility's cash price is $50.00, which matches the median negotiated rate and the median paid amount across all payers. This service is provided by a Critical Access Hospital owned by a Government Hospital District. While the facility's cash price aligns with the median negotiated rate of $50.00, patients should note that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can reduce the final bill by bypassing administrative processing fees.
The Medicare benchmark for this procedure is $53.24, which serves as a reliable baseline for evaluating the facility's pricing structure. Although the data does not provide specific state or county average figures for comparison, the facility's cash rate of $50.00 is slightly below the Medicare amount, suggesting a competitive pricing model relative to federal standards. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services like laboratory tests are performed by out-of-network providers. To ensure accuracy and avoid errors, consumers should request a full itemized bill that lists specific CPT codes rather than accepting broad summary categories, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.