Blood antibody screen
Facility: Greenwood County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $107
- Cash Discount Price: $102
- vs. Medicare Baseline: 2.01x 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 201% of the Medicare baseline (a markup of 101%). 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 |
|---|---|---|
| UnitedHealthcare | $12 - $107 | 23% |
| Blue Cross Blue Shield | $20 - $21 | 38% |
| Triwest - All Plans | $45 | 85% |
| Tricare | $53 | 100% |
| Choicecare Mcr Adv - All Plans | $53 | 100% |
| Integrated Health Plan - All Plans | $95 | 178% |
| Beech Street - All Plans | $108 | 203% |
| First Health Ccn Network | $108 | 203% |
| First Health - All Other Plans | $108 | 203% |
| Preferred Hs (Coventry) - All Plans | $114 | 214% |
| Principal Health Care Inc - All Plans | $121 | 227% |
| Medicaid / KanCare | $127 | 239% |
| Amerigroup Mcaid-All Plans | $127 | 239% |
| Providrs Care/Wppa - All Plans | $190 | 357% |
Consumer Guidance & Cost Commentary
For this blood antibody screen procedure at Greenwood County Hospital in Eureka, Kansas, the negotiated rates for major payers range from $12 to $190, with a median negotiated amount of $107. This median is notably higher than the facility's cash median of $102 and its Medicare benchmark of $53.24. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that cash-paying can sometimes result in lower out-of-pocket costs, particularly for those with high-deductible plans where the insurance negotiated rate exceeds the cash price. To maximize savings, it is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
The data indicates that the facility's pricing structure is heavily influenced by insurance contracts, with the highest negotiated rate reaching $190 for Providrs Care/Wppa. However, the Medicare amount of $53.24 serves as a critical baseline for evaluating the true cost of care, revealing that commercial rates often carry substantial markups compared to the federal government's fixed reimbursement rates. Because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, which may obscure unbundled codes or services not rendered. If a balance bill arises from out-of-network ancillary services, the No Surprises Act may protect patients from paying the difference, so disputing unexpected charges with the insurer and requesting an audit is a recommended step to ensure fair pricing.