Blood antibody screen
Facility: Sheridan County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $78
- Cash Discount Price: $109
- vs. Medicare Baseline: 1.47x 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 |
|---|---|---|
| Celtic Insurance | $37 - $94 | 69% |
| UnitedHealthcare | $58 - $148 | 109% |
| Blue Cross Blue Shield | $61 - $126 | 115% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT 86850) at Sheridan County Hospital in Hoxie, KS, the cash price is $109.00, which matches the facility's median cash rate. This cash price is significantly lower than the negotiated rates paid by major insurers like UnitedHealthcare ($58–$148), Celtic Insurance ($37–$94), and Blue Cross Blue Shield ($61–$126). Because commercial insurance contracts often include administrative overheads that inflate the baseline price by 20% to 40%, patients with high-deductible plans may find paying the cash price of $109.00 more cost-effective than relying on insurance, especially if their deductible is not yet met. It is important to note that while the facility is a Critical Access Hospital owned by the local government, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final amount owed.
The facility's pricing is also evaluated against federal benchmarks; the Medicare amount for this service is $53.24, and the commercial negotiated rate is approximately 1.5 times the Medicare rate. While the data does not provide specific state or county average comparisons for this exact code, the disparity between the cash price and the insurer's negotiated range highlights the potential for balance billing if a patient receives care from an out-of-network provider or if ancillary services are billed separately. To avoid unexpected costs, consumers should request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not