Blood antibody screen
Facility: Rawlins County Health Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $200
- Cash Discount Price: $196
- vs. Medicare Baseline: 3.76x 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 376% of the Medicare baseline (a markup of 276%). 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 | $91 | 171% |
| UnitedHealthcare | $200 | 376% |
Consumer Guidance & Cost Commentary
For the "Blood antibody screen" procedure at Rawlins County Health Center in Atwood, KS, the cash price is $196.00, which is lower than the facility's gross charge of $230.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data indicates that the cash rate is significantly higher than the Medicare benchmark of $53.24. This suggests that for patients with high-deductible plans or those without insurance, paying cash directly may be the most cost-effective option, as the negotiated rates with Blue Cross Blue Shield ($91) and UnitedHealthcare ($200) exceed the cash price. It is important to note that commercial negotiated rates often include administrative overhead and do not reflect the true cost of care, which is better represented by the Medicare rate.
Patients should be aware that while the facility offers a cash rate, they should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these can further reduce the final amount owed. If you are using insurance, be cautious of balance billing, which occurs when a provider bills you for the difference between their full charge and what your insurance pays, though the No Surprises Act protects you from this for emergency care and non-emergency services at in-network facilities. To ensure you are not overcharged, always request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Disputing these errors in writing is the most effective way to reduce medical debt and ensure you only pay for the care you received.