Blood antibody screen
Facility: Stafford County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $42
- Cash Discount Price: $99
- vs. Medicare Baseline: 0.79x 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 |
|---|---|---|
| Va Ccn-All Plans | $4 - $15 | 8% |
| UnitedHealthcare | $4 - $15 | 8% |
| Health Partners-All Plans | $41 - $148 | 77% |
| Medica Mcr- All Plans | $43 - $156 | 81% |
| Humana | $43 - $156 | 81% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Stafford County Hospital lists a cash price of $99.00, which matches the cash median for this service. This cash rate is significantly lower than the facility's negotiated rates, where payers such as Health Partners and Medica Mcr have contracted amounts ranging from $41 to $156. While commercial insurance contracts often result in higher allowed amounts than cash prices, patients with high-deductible plans may find paying the $99.00 cash price more cost-effective if their insurance deductible has not yet been met. It is important to note that the facility is a Critical Access Hospital in Stafford, KS, and while the cash price is competitive, patients should verify their specific plan's allowed amount to determine if the insurance negotiated rate is lower than the cash option.
The Medicare benchmark for this procedure is $53.24, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash price of $99.00 represents a markup relative to the Medicare rate, a common practice in commercial billing where administrative costs and profit margins are factored in. To minimize potential balance billing or unexpected charges, patients should request a prompt-pay discount before scheduling, as hospitals often offer reductions for upfront payment that bypass the standard insurance billing cycle. Additionally, since over 80% of hospital bills contain errors, patients should insist on receiving an itemized bill that details every CPT code and charge rather than accepting a summary invoice, ensuring they can identify any unbundled services or charges for items not rendered.