Blood antibody screen
Facility: Hodgeman County Health Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $87
- Cash Discount Price: $79
- vs. Medicare Baseline: 1.63x 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 |
|---|---|---|
| Triwest - All Plans | $63 | 118% |
| UnitedHealthcare | $63 - $94 | 118% |
| Medicaid / KanCare | $63 - $99 | 118% |
| Humana | $63 | 118% |
| Aetna | $79 | 148% |
| Blue Cross Blue Shield | $87 - $91 | 163% |
| First Health - All Plans | $89 | 167% |
| Wppa (Provdrscare) - All Plans | $94 | 177% |
| Health Partners - All Plans | $94 | 177% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT 86850) at Hodgeman County Health Center in Jetmore, KS, the facility's cash price of $79.00 is significantly lower than the negotiated rates charged to most insurance plans, which range from $63 to $99 depending on the carrier. While the facility is a Critical Access Hospital owned by the local government, its cash rate aligns closely with the lowest end of the insurance spectrum, with some payers like UnitedHealthcare and Medicaid/KanCare having negotiated rates as high as $94.00 to $99.00. This disparity highlights that for patients with high-deductible plans, paying the cash price upfront can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the patient's deductible has not yet been met.
To minimize potential surprise costs, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these programs often offer additional reductions for upfront payment and bypass the administrative overhead associated with insurance claims. It is also important to understand that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur for ancillary services or if a summary bill is accepted without review. Consumers are encouraged to request a full, itemized CPT-coded bill to verify that all charges are accurate and to dispute any errors formally in writing, ensuring they are not paying for services that were not rendered or for unbundled components of the procedure.