Blood antibody screen
Facility: Wilson Medical Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $144
- Cash Discount Price: $135
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $21 - $180 | 39% |
| Ambetter / Centene | $95 - $180 | 178% |
| UnitedHealthcare | $95 - $167 | 178% |
| Tricare | $95 | 178% |
| Aetna | $95 - $180 | 178% |
| Humana | $95 | 178% |
| Cigna | $144 | 270% |
| Mulitplan-All Plans | $166 | 312% |
| Health Partners-All Plans | $166 | 312% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Wilson Medical Center in Neodesha, KS, lists a gross charge of $180.00. While the facility's cash median price is $135.00, which is lower than the state average of $144.00, commercial insurance negotiated rates vary significantly. Payers such as Tricare, Humana, and Cigna have fixed negotiated rates of $95.00 or $144.00, whereas others like Blue Cross Blue Shield and Aetna range from $95.00 to $180.00. Because commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures, patients with high-deductible plans may find paying the cash median of $135.00 directly to the hospital more cost-effective than relying on insurance, provided they qualify for the self-pay rate.
To ensure you receive the most accurate pricing, it is essential to request a prompt-pay discount before scheduling your visit, as hospitals often offer immediate fee reductions for upfront payments that bypass standard insurance billing cycles. Additionally, if you are billed for services rendered by out-of-network providers at this facility, you may be protected under the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network hospitals. If you receive a bill that appears to include unexpected charges, you should demand a full itemized audit rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Always verify your specific plan's deductible status and contact the hospital directly to confirm whether