Blood antibody screen
Facility: Logan County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $129
- Cash Discount Price: $35
- vs. Medicare Baseline: 2.42x 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 242% of the Medicare baseline (a markup of 142%). 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 |
|---|---|---|
| Humana | $74 | 139% |
| Blue Cross Blue Shield | $91 | 171% |
| Health Partners - All Plans | $166 | 312% |
| Medicaid / KanCare | $175 | 329% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Logan County Hospital in Oakley, KS, has a cash median price of $35.00, which is significantly lower than the state average of $120.00. While the facility's negotiated rates with payers like Humana and Blue Cross Blue Shield range from $74 to $175, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $35.00. It is important to note that commercial rates often include administrative overhead and contract markups, whereas the cash price reflects the direct cost of the service without insurance processing fees.
To ensure you are receiving the most accurate pricing, always request an itemized bill before paying, as summary bills can obscure individual charges or double-billing errors. If you choose to pay out-of-pocket, ask specifically about "self-pay" or "prompt-pay" discounts, which can further reduce the cost by bypassing the administrative costs associated with insurance claims. Additionally, compare your facility's rates against the Medicare benchmark of $53.24; while the hospital's negotiated rates are higher, the cash price remains well below the Medicare amount, offering a clear opportunity for cost savings if you are eligible to pay directly.