Blood antibody screen
Facility: Osborne County Memorial Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $112
- Cash Discount Price: $105
- vs. Medicare Baseline: 2.10x 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 210% of the Medicare baseline (a markup of 110%). 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 |
|---|---|---|
| UnitedHealthcare | $93 | 175% |
| Health Partners Of Kansas | $106 | 199% |
| Wppa | $117 | 220% |
| Blue Cross Blue Shield | $121 | 227% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, representing a blood antibody screen at Osborne County Memorial Hospital in Osborne, KS, the facility's cash price of $105.00 is notably lower than the state average. While the hospital's negotiated rates for in-network payers range from $93.00 to $121.00, these amounts are generally higher than the cash price due to administrative overhead and contract structures. It is important to note that while insurance contracts often set a maximum allowed amount, the actual patient cost depends on your specific deductible status; if you have not yet met your deductible, you may be responsible for the full negotiated rate, which could exceed the cash price. Additionally, the facility's cash rate is significantly lower than the Medicare benchmark of $53.24, indicating that the commercial negotiated rates include substantial markups relative to the federal baseline.
Patients should be aware that the facility, a Critical Access Hospital with government-local ownership, offers a cash median of $105.00, which serves as a potential baseline for self-pay patients. To minimize out-of-pocket costs, it is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Furthermore, since the facility is in-network for four major payers, the No Surprises Act protects patients from balance billing for out-of-network services at this location, though it is still prudent to request an itemized bill to verify that no unbundled codes or services not rendered have been charged. Always confirm your deductible balance before scheduling, as paying the cash price upfront may be more