Blood antibody screen
Facility: Stevens County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $91
- Cash Discount Price: $165
- vs. Medicare Baseline: 1.71x 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 |
|---|---|---|
| Aetna | $16 - $165 | 30% |
| Humana | $61 | 115% |
| Blue Cross Blue Shield | $87 - $91 | 163% |
| First Health - All Plans | $148 | 278% |
| Wppa - All Plans | $157 | 295% |
| Medicaid / KanCare | $165 | 310% |
Consumer Guidance & Cost Commentary
For the blood antibody screen procedure (CPT 86850) at Stevens County Hospital in Hugoton, Kansas, the cash price is $165.00, which matches the facility's gross charge and the median amount paid by Medicaid/KanCare. While the facility's negotiated rates for commercial payers like Aetna and Blue Cross Blue Shield range from $61 to $165, the cash price remains the highest single value in this dataset. It is important to note that for patients with high-deductible plans, paying the cash price of $165.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates for some commercial payers may exceed this amount. Additionally, patients should verify if the hospital offers self-pay or prompt-pay discounts, which could reduce the final out-of-pocket cost before services are rendered.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this code is $53.24, and the facility's cash price is 1.7 times the Medicare rate, indicating a significant markup relative to the federal baseline. Since over 80% of hospital bills often contain errors, patients should request a detailed, itemized billing audit to ensure no unbundled codes or services not rendered are included in the final invoice. If a balance bill arises from out-of-network ancillary services, the No Surprises Act provides federal protections that may prevent patients from being charged the difference between the provider's full rate and the insurance allowed amount, so patients should dispute any unexpected bills in writing rather than paying immediately.