Blood antibody screen
Facility: Norton County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $128
- Cash Discount Price: $98
- vs. Medicare Baseline: 2.40x 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 240% of the Medicare baseline (a markup of 140%). 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 | $128 | 240% |
Consumer Guidance & Cost Commentary
For the "Blood antibody screen" procedure at Norton County Hospital, the cash price of $98.00 is notably lower than the median negotiated rate of $128.00 charged by Blue Cross Blue Shield. While the facility is a Critical Access Hospital in Norton, Kansas, with a government-local ownership structure, patients with high-deductible plans may find paying the cash price upfront more economical than using insurance, as the negotiated rate exceeds the cash amount. To maximize savings, it is advisable to explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly claims processing and administrative overhead.
The Medicare amount for this service is $53.24, which serves as a key benchmark for evaluating the facility's pricing markup. Although the data does not provide specific state or county average comparisons for this code, the significant difference between the Medicare rate and the cash price highlights the potential for substantial savings when paying directly. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to verify that all ancillary services, such as lab tests, are covered under the facility's network agreements to avoid unexpected charges. Always request a detailed, itemized bill before payment to ensure no unbundled codes or services not rendered are included in the final invoice.