Blood antibody screen
Facility: St Luke Hospital & Living Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $57
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.07x 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 | $39 - $73 | 73% |
| Blue Cross Blue Shield | $39 - $73 | 73% |
| Bluestem Pace | $39 - $73 | 73% |
| Va Ccn | $39 - $73 | 73% |
| Kansas Department Of Health And Environment | $39 - $73 | 73% |
| Humana | $39 - $73 | 73% |
| Ambetter / Centene | $40 - $74 | 75% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, Blood antibody screen, St Luke Hospital & Living Center in Marion, KS, has a gross charge of $111.00. This facility is a Critical Access Hospital owned by a Government Hospital District, and its negotiated rates range from $39 to $74 across seven payers, with a median negotiated amount of $57.00. The Medicare benchmark for this service is $53.24, which serves as the objective baseline for evaluating pricing markups. While the facility's negotiated rates are slightly higher than the Medicare rate, they remain within the typical range for commercial contracts. It is important to note that cash-pay options are not listed for this code, so patients should verify if self-pay or prompt-pay discounts are available directly with the hospital before scheduling, as these can sometimes result in lower out-of-pocket costs than insurance negotiated rates.
Patients should be aware that commercial insurance rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to the true cost of care. Although the data provided does not include specific state or county average comparisons for this code, the facility's pricing structure relies on the Medicare benchmark of $53.24 to establish fair value. If you have a high-deductible plan, paying cash might be more economical if the insurance allowed amount exceeds the cash price, though no cash rate is currently available for this service. To ensure you are receiving the most accurate pricing, always request an itemized billing audit to review every line item and confirm that no services were unbundled or incorrectly charged before finalizing payment.