Blood antibody screen
Facility: Phillips County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $99
- Cash Discount Price: $91
- vs. Medicare Baseline: 1.86x 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 |
|---|---|---|
| UnitedHealthcare | $79 - $116 | 148% |
| Blue Cross Blue Shield | $80 - $94 | 150% |
| Health Partners-All Plans | $99 - $116 | 186% |
| Medicaid / KanCare | $99 - $116 | 186% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, representing a blood antibody screen, the cash median price at Phillips County Hospital in Phillipsburg, KS, is $91.00, while the facility's median negotiated rate with insurance payers is $99.00. This specific service is priced at 1.9 times the Medicare benchmark amount of $53.24. Because the cash price is lower than the negotiated rates, patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price of $91.00 directly, provided they confirm with the hospital that this rate applies to self-pay patients and that no additional administrative fees are added.
It is important to note that while the facility is a Critical Access Hospital owned by the local government, the data reflects specific pricing for this laboratory service rather than a general hospital average. Patients should be aware that commercial insurance contracts often result in negotiated rates that exceed cash prices due to administrative overhead and contract dynamics, meaning the "in-network" status does not guarantee the lowest possible cost for this test. To ensure you are receiving the best possible rate, you should explicitly request a self-pay or prompt-pay discount before scheduling, as these upfront payment incentives can further reduce the final amount owed compared to the standard cash median.