Blood antibody screen
Facility: Cheyenne County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $144
- Cash Discount Price: $152
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 |
|---|---|---|
| UnitedHealthcare | $15 - $152 | 28% |
| Blue Cross Blue Shield | $21 | 39% |
| First Health - All Plans | $106 | 199% |
| Aetna | $109 - $144 | 205% |
| Healthy Blue Mcr Adv | $109 | 205% |
| Tricare | $109 | 205% |
| Choice Care - All Plans | $110 | 207% |
| Firstguard - All Plans | $121 | 227% |
| Wppa - All Plans | $137 | 257% |
| Cpm - All Plans | $144 | 270% |
| Preferred Hc - All Plans | $144 | 270% |
| Midlands Choice - All Plans | $147 | 276% |
| Ppo Next - All Plans | $149 | 280% |
| Unicare - All Plans | $149 | 280% |
| Health Partners - All Plans | $149 | 280% |
| Integrated Hp - All Plans | $149 | 280% |
| Healthwave Mcaid - All Plans | $152 | 285% |
| Childrens Mercy - All Plans | $152 | 285% |
| Healthy Blue Mcaid - All Other Plans | $152 | 285% |
| Providers Care-All Plans | $228 | 428% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Cheyenne County Hospital lists a cash price of $152.00, which matches the facility's median paid amount and the gross charge. This cash rate is significantly higher than the Medicare benchmark of $53.24, reflecting a markup of 2.7 times the federal rate. While commercial payers negotiate rates ranging from $15 to $228, the cash price remains the lowest available option for patients without insurance. For individuals with high-deductible plans, paying the $152.00 cash price may be more cost-effective than relying on insurance, as many negotiated rates exceed the cash amount due to administrative overhead and contract structures.
Patients should verify their specific plan details before scheduling, as some in-network rates can be substantially higher than the cash price. It is important to request an itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal audit. Additionally, patients should inquire about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle. Given that this facility is a Critical Access Hospital in Kansas, comparing these rates to local averages helps identify fair pricing, though the data provided does not include specific county or state average figures for this code.