Blood antibody screen
Facility: Wichita County Health Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $121
- Cash Discount Price: $106
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| Medicaid / KanCare | $110 | 207% |
| UnitedHealthcare | $133 | 250% |
Consumer Guidance & Cost Commentary
For the "Blood antibody screen" procedure (CPT 86850) at Wichita County Health Center in Leoti, KS, the facility's negotiated rates range from $110 to $133, with a median paid amount of $110.00. This negotiated rate is significantly higher than the Medicare benchmark of $53.24, reflecting the standard administrative and contract structures that inflate commercial pricing. While the facility is a Critical Access Hospital with government-local ownership, the data indicates that the cash median price of $106.00 is lower than the negotiated amount, suggesting that patients with high-deductible plans or those without insurance might save money by paying cash directly, provided they secure a "self-pay" or "prompt-pay" discount before scheduling.
It is important to note that the $133.00 gross chargemaster price is the maximum amount billed before insurance negotiations, and the actual cost to patients depends on their specific plan. Since the data does not provide specific county or state average comparisons for this procedure, patients should verify their individual plan's allowed amount before relying on the facility's negotiated rate. To ensure you are not overpaying, always request a detailed itemized bill to confirm that no services were bundled incorrectly or that charges for items not rendered were included. If you receive a balance bill for out-of-network ancillary services, you may be entitled to protections under the No Surprises Act, and you should dispute the bill in writing rather than paying immediately.