Blood antibody screen
Facility: Kearny County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $262
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.92x 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 492% of the Medicare baseline (a markup of 392%). 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 | $262 - $524 | 492% |
| Aetna | $262 | 492% |
| Blue Cross Blue Shield | $262 | 492% |
| Meritain Health | $262 | 492% |
| Humana | $262 | 492% |
| Community Care Health Plan Of | $262 | 492% |
| Luminare Health | $262 | 492% |
| Wps Gha - Mac J5 Part A | $262 | 492% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," the facility in Lakin, KS, has a gross charge of $262.00. While the facility's negotiated rate averages $262.00 across its eight payer plans, the actual amount paid to the hospital is significantly lower, with a median paid amount of $13.00. This substantial difference highlights the importance of understanding the gap between what insurance contracts allow and the final reimbursement received. For patients with high-deductible plans, it is often more cost-effective to pay the cash price directly, as the cash median is not listed but the negotiated rate far exceeds the actual paid amount, suggesting that paying out-of-pocket could result in immediate savings compared to the administrative costs embedded in the insurance process.
When evaluating the true cost of this service, it is essential to compare rates against the Medicare benchmark rather than the facility's gross charge. The Medicare amount for this procedure is $53.24, which serves as a scientifically validated baseline for the cost of care. The facility's negotiated rate of $262.00 represents a significant markup over the Medicare rate of $53.24, illustrating how commercial rates can exceed fair pricing standards. Additionally, patients should inquire about "prompt-pay" discounts or self-pay rates before scheduling, as these upfront payment incentives can bypass the administrative overhead of insurance billing and potentially lower the final cost. Given that this is a Critical Access Hospital with government-local ownership, verifying the specific self-pay or prompt-pay discounts available directly with the billing department is the most effective way to minimize out-of-pocket expenses.