Blood antibody screen
Facility: Holton Community Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $43
- Cash Discount Price: $39
- vs. Medicare Baseline: 0.81x 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 |
|---|---|---|
| Blue Cross Blue Shield | $21 | 39% |
| Humana | $28 | 53% |
| Aetna | $28 - $52 | 53% |
| UnitedHealthcare | $28 - $52 | 53% |
| Kansas Superior Select - All Plans | $28 | 53% |
| Preferred Health Fn Select - All Other Plans | $43 | 81% |
| Preferred Health Freedom | $43 | 81% |
| Preferred Health Professionals | $43 | 81% |
| Wppa Providers - All Plans | $49 | 92% |
| Medicaid / KanCare | $52 | 98% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT 86850) at Holton Community Hospital, the cash median price is $39.00, which is lower than the facility's negotiated rates of $43.00 and the gross charge of $52.00. While the facility is a Critical Access Hospital in Holton, KS, the data does not provide specific county or state average benchmarks for this procedure to compare against. However, the cash price of $39.00 is notably lower than the Medicare benchmark of $53.24, suggesting that paying out-of-pocket may be more cost-effective for patients with high-deductible plans or those without insurance, as the insurance negotiated rates often exceed the cash price due to administrative overhead.
Patients should verify their specific plan details before scheduling, as the negotiated rates vary significantly by payer, ranging from $21.00 for Blue Cross Blue Shield to $52.00 for Aetna and UnitedHealthcare. If you are self-pay, you may be eligible for a prompt-pay discount by requesting a self-pay classification at check-in, which can reduce the bill further. Additionally, because the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you can dispute any unexpected charges by requesting an itemized billing audit to ensure all services are accurately coded and no unbundled fees are included.