Blood antibody screen
Facility: Republic County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $51
- Cash Discount Price: $44
- vs. Medicare Baseline: 0.96x 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 |
|---|---|---|
| Rural Carriers-All Plans | $35 - $64 | 66% |
| Meritain-All Plans | $37 - $68 | 69% |
| Aetna | $37 - $68 | 69% |
| UnitedHealthcare | $38 - $69 | 71% |
| Cigna | $39 - $71 | 73% |
| First Health-All Plans | $39 - $71 | 73% |
| Midlands Choice-All Plans | $39 - $71 | 73% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, representing a blood antibody screen, Republic County Hospital in Belleville, KS, lists a cash price of $44.00 and a median negotiated rate of $51.00. This cash price is lower than the facility's Medicare benchmark of $53.24, which serves as the objective baseline for fair pricing. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance rates often exceed cash prices due to administrative costs and contract dynamics. If you have a high-deductible plan, paying the cash price of $44.00 upfront may result in significant savings compared to your insurance's allowed amount, which averages between $35.00 and $71.00 depending on your specific carrier.
To ensure you are not overcharged, it is crucial to request a full itemized billing audit before paying any invoice, as summary bills often obscure individual code costs. If you receive a balance bill for the difference between the provider's rate and your insurance payment, you may be protected under the No Surprises Act, which bans such billing for emergency care and non-emergency services at in-network facilities. Additionally, you should inquire about prompt-pay discounts, which can reduce the final amount by 20% to 50% if settled within 30 days, effectively bypassing the costly claims processing cycle. Always verify your deductible status and ask for self-pay rates prior to scheduling to avoid unexpected financial burdens.