Blood antibody screen
Facility: Stanton County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $104
- Cash Discount Price: $75
- vs. Medicare Baseline: 1.95x 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 |
|---|---|---|
| Blue Cross Blue Shield | $87 - $230 | 163% |
| Healthy Blue Mcr Adv - All Other Plans | $103 - $238 | 193% |
| Healthy Blue Mcaid | $105 - $207 | 197% |
Consumer Guidance & Cost Commentary
For the "Blood antibody screen" procedure at Stanton County Hospital in Johnson, KS, the cash price is $75.00, which matches the facility's cash median. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates paid by commercial payers like Blue Cross Blue Shield range from $87 to $230, significantly higher than the cash option. This disparity highlights a common billing pitfall where patients assume in-network coverage guarantees the lowest price; in this case, paying out-of-pocket for $75.00 could save money compared to the insurance negotiated rates, especially if your plan has a high deductible or you have already met your out-of-pocket maximum.
To maximize savings, we recommend requesting a "prompt-pay" discount from the hospital before scheduling your visit, as paying in full upfront often triggers a fee reduction that bypasses the administrative costs of insurance claims processing. Additionally, it is important to compare these rates against the broader market; while specific county or state averages are not provided in this dataset, the Medicare benchmark for this service is $53.24. Commercial negotiated rates frequently exceed the Medicare rate by 200% to 300%, so using the Medicare amount as a baseline helps verify if the facility's pricing is reasonable. If you receive a bill after using insurance, always request an itemized audit to ensure no errors exist before agreeing to pay the full difference.