Blood antibody screen
Facility: Mercy Hospital Columbus
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $75
- Cash Discount Price: $66
- vs. Medicare Baseline: 1.41x 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 |
|---|---|---|
| Centivo Contracted [320505] | $1 | 2% |
| Humana | $9 - $96 | 17% |
| Medicaid / KanCare | $9 - $73 | 17% |
| Blue Cross Blue Shield | $23 - $119 | 43% |
| Insurance System Inc Contracted [320465] | $43 | 81% |
| Health Systems Inc Contracted [320174] | $43 | 81% |
| Administrative Payor Contracted [320005] | $45 | 85% |
| UnitedHealthcare | $46 - $84 | 86% |
| Medicare (plans) | $50 - $76 | 94% |
| Mercy Hospice Okc [20252] | $73 | 137% |
| Aetna | $73 - $91 | 137% |
| Pace Of The Ozarks Contracted [320518] | $73 | 137% |
| Indian Health Service Contracted [320198] | $73 | 137% |
| Cigna | $73 | 137% |
| Kindful Hospice Contracted [320434] | $73 | 137% |
| Dept Of Veteran Affairs Contracted [320106] | $73 | 137% |
| Ambetter / Centene | $73 | 137% |
| Medical Associates Health Contracted [320444] | $73 | 137% |
| Centurion Of Missouri [20459] | $73 | 137% |
| Globalhealth Contracted [320145] | $73 | 137% |
| Cross Timbers Hospice [20098] | $73 | 137% |
| Home State Health Plan Contracted [320187] | $73 | 137% |
| Halo Hcr Inc Hospice Contracted [320432] | $73 | 137% |
| Elara Caring Aspire Hospice [20433] | $73 | 137% |
| Cherokee Nation Health Serv Contracted [320066] | $73 | 137% |
| Kindful Hospice [20434] | $73 | 137% |
| Novasys Contracted [320285] | $73 | 137% |
| Mercy Mgd Behavioral Health Contracted [320259] | $73 | 137% |
| Provider Partners Health Plans Contracted [320450] | $73 | 137% |
| Halo Hcr Inc Hospice [20432] | $73 | 137% |
| Qual Choice Contracted [320325] | $73 | 137% |
| Tricare | $74 | 139% |
| Healthscope Contracted [320182] | $78 | 147% |
| Workers Comp [20426] | $81 - $86 | 152% |
| United Medical Resources Contracted [320454] | $84 - $96 | 158% |
| Medica Contracted [320239] | $90 | 169% |
| Healthlink Contracted [320179] | $91 - $96 | 171% |
| Preferred Health Plan Contracted [320522] | $91 | 171% |
| First Health Contracted [320128] | $91 | 171% |
| American Healthcare Alliance Contracted [320020] | $91 | 171% |
| Usa Managed Care Org Contracted [320429] | $91 | 171% |
| Federal Medical Center Contracted [320127] | $91 | 171% |
| Mercy Benefit Admin Contracted [320251] | $91 - $96 | 171% |
| Ppo Plus Contracted [320310] | $96 | 180% |
| Aither Health Contracted [320449] | $96 | 180% |
| Reflect Health Contracted [320492] | $96 | 180% |
| Private Health Care Systems Contracted [320320] | $96 | 180% |
| Show-Me Health Administrators Contracted [320483] | $96 | 180% |
| 90 Degree Benefits Contracted [320436] | $96 | 180% |
| Yuzu Health Contracted [320521] | $96 | 180% |
| Benefit Management Contracted [320052] | $96 | 180% |
| Edison Health Solutions Contracted [320502] | $96 | 180% |
| Auxiant Contracted [320462] | $96 | 180% |
| Imagine 360 Contracted [320494] | $96 | 180% |
| Ebms Contracted [320493] | $96 | 180% |
| Point C Contracted [320238] | $96 | 180% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, Blood antibody screen, Mercy Hospital Columbus lists a cash price of $101.00, which is notably higher than the facility's own cash median of $66.00. While the gross charge of $101.00 is significantly above the Medicare benchmark of $53.24—indicating a markup typical of commercial billing structures—the facility offers a negotiated rate of $75.00, which sits between the cash price and the Medicare amount. This suggests that for patients with high-deductible plans or those paying out-of-pocket, the cash price of $101.00 may not be the most economical option, as the negotiated rate of $75.00 could represent a lower effective cost depending on the patient's specific insurance coverage and deductible status.
Patients should be aware that while many payers in the network have negotiated rates ranging from $1 to $96, the actual amount paid depends heavily on individual plan terms. It is crucial to request an itemized bill before finalizing payment to ensure no errors, unbundled codes, or services not rendered are included, as over 80% of hospital bills contain such discrepancies. Additionally, patients should inquire about "prompt-pay" discounts, which can reduce the total bill by 20% to 50% if paid in full upfront, effectively bypassing the administrative costs associated with insurance claims processing.