Blood antibody screen
Facility: Graham County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $56
- Cash Discount Price: $122
- vs. Medicare Baseline: 1.05x 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 |
|---|---|---|
| UnitedHealthcare | $12 - $116 | 23% |
| Medicaid / KanCare | $13 | 24% |
| Blue Cross Blue Shield | $21 | 39% |
| Medicare (plans) | $92 | 173% |
| Celtic Commercial-All Other Plans | $101 | 190% |
| Wppa (Providers Care)-All Plans | $116 | 218% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Graham County Hospital in Hill City, KS, lists a cash price of $122.00, which matches the state average for this service. While the facility's cash rate aligns with the broader market, commercial insurance plans often pay significantly higher amounts due to administrative overhead and contract structures. For instance, UnitedHealthcare's negotiated rate ranges from $12 to $116 across three plans, while Celtic Commercial-All Other Plans and Wppa (Providers Care) both pay the full $116. This illustrates that in-network coverage does not guarantee the lowest possible price; in some cases, paying cash directly can be more cost-effective than relying on insurance negotiations that include multi-layered administrative costs.
Patients should be aware that Medicare, which serves as the objective baseline for fair pricing, pays $53.24 for this procedure, meaning the cash price is approximately 110% of the Medicare rate—a figure that falls within the typical range for fair commercial pricing. Medicaid / KanCare pays the lowest rate at $13, while other payers like Blue Cross Blue Shield and Medicare (plans) pay $21 and $92 respectively. To further reduce costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can lower the final amount by 20% to 50% if settled upfront. Additionally, since over 80% of hospital bills contain errors, it is advisable to request a full itemized statement before paying to ensure no unbundled charges or services not rendered are included.