Blood antibody screen
Facility: Kiowa County Memorial Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $161
- Cash Discount Price: $154
- vs. Medicare Baseline: 3.02x 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 302% of the Medicare baseline (a markup of 202%). 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 | $91 - $161 | 171% |
| UnitedHealthcare | $145 - $181 | 272% |
| Health Partners Of Ks-All Plans | $159 | 299% |
| Humana | $161 | 302% |
| Celtic Comml Exchange-All Other Plans | $161 | 302% |
| Aetna | $161 | 302% |
| Medica Prime Mcare Cost-All Plans | $161 | 302% |
| Medicaid / KanCare | $181 | 340% |
| Providrs Care/Wppa-All Plans | $272 | 511% |
Consumer Guidance & Cost Commentary
For CPT code 86850, a blood antibody screen, Kiowa County Memorial Hospital in Greensburg, KS, has a cash median price of $154.00 and a median negotiated rate of $161.00. This cash price is notably lower than the facility's gross charge of $181.00 and aligns closely with the state average for this service. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rate of $161.00 exceeds the cash option. It is important to note that while the facility offers a cash median of $154.00, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially reduce the final amount owed.
Patients should be aware that commercial insurance rates often differ significantly from Medicare benchmarks; for this specific code, the Medicare amount is $53.24, which serves as a baseline for evaluating the facility's pricing structure. Although the negotiated rates for major payers like Blue Cross Blue Shield and UnitedHealthcare range from $91.00 to $161.00, the presence of Medicaid/KanCare at $181.00 and Providrs Care/Wppa at $272.00 highlights the variability in allowed amounts across different plans. To avoid unexpected costs, consumers should request an itemized bill to ensure no services were unbundled or double-charged, as over 80% of hospital bills contain errors. If a balance bill arises from an