Blood antibody screen
Facility: Kiowa District Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $173
- Cash Discount Price: $146
- vs. Medicare Baseline: 3.25x 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 325% of the Medicare baseline (a markup of 225%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $21 | 39% |
| Tricare | $71 | 133% |
| Healthchoice-All Plans | $74 | 139% |
| UnitedHealthcare | $146 - $183 | 274% |
| Health Partners Of Ks-All Plans | $161 | 302% |
| Humana | $165 | 310% |
| Gbs Insurance - All Plans | $172 | 323% |
| Multiplan-All Plans | $172 | 323% |
| Aetna | $174 | 327% |
| Medicare (plans) | $174 | 327% |
| Triwest-All Plans | $174 | 327% |
| Medicaid / KanCare | $183 | 344% |
| Providers Care (Wppa)-All Plans | $274 | 515% |
| Liberty Healthshare-All Plans | $296 | 556% |
Consumer Guidance & Cost Commentary
For the CPT code 86850 (Blood antibody screen) at Kiowa District Hospital in Kiowa, Kansas, the cash median price is $146. This facility, a government-owned Critical Access Hospital, lists a gross charge of $183, while the median negotiated rate across payers is $173 and the median paid rate is $172. The facility's cash price of $146 is notably lower than the Medicare amount of $53.24, which serves as the federal benchmark for this service.
When comparing rates, the facility's cash price of $146 is significantly lower than the highest negotiated rate of $296 charged by Liberty Healthshare-All Plans and the gross charge of $183. While the median negotiated rate of $173 is close to the cash price, patients should verify if their specific insurance plan, such as UnitedHealthcare or Medicaid/KanCare, pays the full gross amount of $183, as this would make the cash price of $146 a substantial savings. Consumers should check with the hospital for "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can sometimes be cheaper than the insurance negotiated rate, especially if the plan has a high deductible or does not fully cover the service.