Blood antibody screen
Facility: Medicine Lodge Memorial Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $84
- Cash Discount Price: $95
- vs. Medicare Baseline: 1.58x 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 |
|---|---|---|
| Tricare | $31 - $102 | 58% |
| Humana | $36 - $116 | 68% |
| Aetna | $36 - $128 | 68% |
| UnitedHealthcare | $37 - $121 | 69% |
| Hpk-All Plans | $37 - $121 | 69% |
| Medicaid / KanCare | $39 - $128 | 73% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Medicine Lodge Memorial Hospital in Medicine Lodge, KS, lists a cash price of $95.00, which matches the facility's median paid amount. This cash rate is notably lower than the state average for this service, as indicated by the facility's median negotiated rate of $84.00, suggesting that paying out-of-pocket may be more cost-effective than relying on insurance for this specific test. Patients with high-deductible plans should consider that while insurance often negotiates a rate (such as the $104.00 median paid by commercial payers), the cash price can sometimes result in lower out-of-pocket costs if the patient's deductible has not yet been met. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the final bill.
The facility's pricing structure is benchmarked against Medicare, with a Medicare amount of $53.24 for this procedure. The cash price of $95.00 represents a 1.6x markup relative to the Medicare rate, which falls within the range of fair pricing typically defined as 120% to 150% of Medicare, indicating a reasonable cost basis for this service. While commercial payers like Tricare, Humana, and Aetna have negotiated rates ranging from $31 to $128 depending on the specific plan, the cash price offers a transparent baseline that avoids the complexities of balance billing or unexpected ancillary charges. Consumers are encouraged to request a full itemized bill to verify that no unbundled