Blood antibody screen
Facility: Community Memorial Healthcare, Inc.
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $35
- Cash Discount Price: $56
- vs. Medicare Baseline: 0.66x 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 |
|---|---|---|
| Aetna | $23 - $46 | 43% |
| UnitedHealthcare | $29 - $35 | 54% |
| Blue Cross Blue Shield | $91 | 171% |
Consumer Guidance & Cost Commentary
For the CPT code 86850 (Blood antibody screen) at Community Memorial Healthcare, Inc. in Marysville, KS, the facility's cash median price is $56.00, which matches the median paid amount. This cash rate is significantly lower than the facility's negotiated rates, with a median negotiated amount of $35.00 and a gross charge of $56.00. While the facility's negotiated rate of $35.00 is lower than the state average for this service, patients should be aware that commercial insurance contracts often include administrative overheads that can inflate the baseline price by 20% to 40% compared to direct cash payments. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $56.00 upfront may result in a lower out-of-pocket cost than the insurance negotiated rate, provided the insurer does not cover the full amount after your deductible is met.
The facility's pricing is also evaluated against the Medicare benchmark, which stands at $53.24 for this procedure. The facility's cash rate of $56.00 is slightly higher than the Medicare amount, indicating that the cash price is already close to the "true cost" of delivery as defined by federal standards. For patients concerned about balance billing, the No Surprises Act protects against unexpected charges for out-of-network services at this Critical Access Hospital, though it is essential to verify that all ancillary services, such as lab draws, are covered under the same network agreement. To ensure you receive the best possible rate, we recommend contacting the hospital directly to confirm their "self-pay" or "prompt-pay