Blood antibody screen
Facility: Hospital District #6 Patterson Health Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $107
- Cash Discount Price: $95
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $20 - $21 | 38% |
| UnitedHealthcare | $107 - $119 | 201% |
| Providers Care (Wppa)-All Plans | $208 | 391% |
Consumer Guidance & Cost Commentary
For the "Blood antibody screen" procedure at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price of $95.00 is notably lower than the state average of $107.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield average $107.00, patients with high-deductible plans may find paying the cash price of $95.00 more cost-effective, as the insurance negotiated rate exceeds the cash amount. It is important to note that this cash price represents a direct comparison to the state average, and patients should verify their specific plan's deductible status before relying on insurance to cover the service, as some plans may still require out-of-pocket payments up to the negotiated rate.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To ensure transparency, consumers should request a full itemized bill before paying, as summary bills often obscure individual code costs and potential errors. Additionally, since the facility offers a cash median price of $95.00, patients should explicitly ask about "self-pay" or "prompt-pay" discounts at registration to potentially reduce their final out-of-pocket costs further, ensuring they are not inadvertently agreeing to higher rates through automatic insurance submission.