Blood antibody screen
Facility: Ashland Health Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $127
- Cash Discount Price: $102
- vs. Medicare Baseline: 2.39x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 239% of the Medicare baseline (a markup of 139%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Blue Cross Blue Shield | $43 | 81% |
| Compalliance-All Plans | $102 | 192% |
| Health Partners Of Kansas-All Plans | $108 - $109 | 203% |
| Multiplan-All Plans | $125 | 235% |
| UnitedHealthcare | $127 - $128 | 239% |
| Medica Mcare - All Plans | $127 - $128 | 239% |
| Health Choice-All Plans | $127 - $128 | 239% |
| Medicare (plans) | $127 - $128 | 239% |
| Aetna | $127 - $128 | 239% |
| Medicaid / KanCare | $127 - $128 | 239% |
| Healthy Blue Mcr Adv - All Other Plans | $127 - $128 | 239% |
| Providers Care (Wppa)-All Plans | $191 - $192 | 359% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Ashland Health Center in Ashland, KS, has a cash median price of $102.00, which is lower than the facility's negotiated rates of $127.00 paid by most insurance plans. While the facility's negotiated rates align with the state average of $127.00, patients should note that paying cash upfront can sometimes be more cost-effective if their insurance plan has a high deductible or if the negotiated rate exceeds the cash price. To maximize savings, consumers are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by offering immediate liquidity incentives that bypass standard insurance billing cycles.
It is important to distinguish between the facility's gross charge of $128.00 and the actual amounts billed to patients. Although the gross charge is only slightly higher than the cash price, the significant difference between the cash rate and the Medicare benchmark of $53.24 highlights how commercial rates can exceed the federal cost baseline. If you receive a bill that appears to include balance billing for out-of-network services, remember that the No Surprises Act protects you from being billed the difference between the provider's full charge and your insurance allowed amount for emergency care or non-emergency services at in-network facilities. Always request a detailed, itemized bill before paying, as summary bills may obscure errors or unbundled charges, and do not sign away your rights to dispute out-of-network costs without fully understanding the terms.