Blood antibody screen
Facility: Great Plains Of Sabetha
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $124
- Cash Discount Price: $133
- vs. Medicare Baseline: 2.33x 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 233% of the Medicare baseline (a markup of 133%). 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 |
|---|---|---|
| Celtic Mcr Adv | $64 - $74 | 120% |
| Aetna | $65 - $143 | 122% |
| Celtic Comm Exchange-All Other Plans | $81 - $92 | 152% |
| Great West Healthcare-All Plans | $105 - $121 | 197% |
| UnitedHealthcare | $115 - $142 | 216% |
| Century/Wppa/Providers-All Plans | $118 - $135 | 222% |
| Humana | $118 - $135 | 222% |
| Cigna | $118 - $135 | 222% |
| Multiplan-Phcs-All Plans | $118 - $135 | 222% |
| Federated Mutual Ins-All Plans | $119 - $136 | 224% |
| Medicaid / KanCare | $124 - $142 | 233% |
| Blue Cross Blue Shield | $124 - $142 | 233% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, representing a blood antibody screen, the cash price at Great Plains Of Sabetha in Sabetha, KS, is $133.00. This cash rate is notably higher than the facility's negotiated average of $124.00 and the median paid amount of $118.00, suggesting that paying out-of-pocket may not be the most economical option for those with active insurance coverage. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific county or state average benchmarks for this procedure, so direct comparisons to regional pricing standards cannot be made based on the available information.
When using insurance, patients should be aware that commercial payers negotiate rates that often exceed cash prices due to administrative costs and contract structures. In this case, the lowest negotiated rate among the 12 payers listed is $64.00 with Celtic Mcr Adv, while the highest is $143.00 with Aetna. It is important to verify your specific plan's deductible status before scheduling, as you may be responsible for the full negotiated amount if you have not yet met your out-of-pocket threshold. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront, effectively bypassing the higher administrative fees associated with insurance claims processing.