Blood antibody screen
Facility: Hamilton County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $103
- Cash Discount Price: $115
- vs. Medicare Baseline: 1.93x 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 | $10 - $91 | 19% |
| First Health Coventry - All Plans | $98 | 184% |
| UnitedHealthcare | $109 | 205% |
| Cigna | $109 | 205% |
| Va Ccn - All Plans | $115 | 216% |
| Aetna | $195 | 366% |
Consumer Guidance & Cost Commentary
For the Blood antibody screen (CPT 86850) at Hamilton County Hospital in Syracuse, KS, the cash price is $115.00, which matches the facility's negotiated rate with UnitedHealthcare, Cigna, and the VA. This cash price is significantly higher than the Medicare benchmark of $53.24, reflecting a markup of 190% above the federal baseline. While the facility is a Critical Access Hospital with government local ownership, the cash rate exceeds the median negotiated rate of $103.00 and the state average of $109.00. Because commercial insurance contracts often include administrative overhead and network tiering, patients with high-deductible plans may find paying the $115.00 cash price directly more cost-effective than relying on an insurance plan that negotiates rates above the cash amount.
Patients should proactively contact the hospital to inquire about self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% for upfront payment. It is important to verify that the facility is in-network for your specific plan to avoid balance billing, though the No Surprises Act protects against surprise out-of-network charges for emergency care and non-emergency services at in-network facilities. Before scheduling, confirm your deductible status, as using insurance for this service may result in a higher out-of-pocket cost if the negotiated rate exceeds your cash price. Finally, if you receive an invoice, request a full itemized bill to ensure no errors or unbundled charges are present, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written audit.