Blood antibody screen
Facility: Scott County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $71
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.33x 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 | $8 - $75 | 15% |
| Humana | $33 | 62% |
| Wppa | $47 - $1,200 | 88% |
| Aetna | $71 | 133% |
| Blue Cross Blue Shield | $91 | 171% |
Consumer Guidance & Cost Commentary
For the CPT code 86850 (Blood antibody screen) at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $8 to $1,200 across five payers, with a median negotiated amount of $71. This figure is notably higher than the facility's cash median, which is not reported in this dataset. While commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and claim processing fees, patients with high-deductible plans may find that paying the cash price directly is more economical if the insurance negotiated rate exceeds the cash price. It is important to note that the facility, a Critical Access Hospital, does not have a reported cash median in this report, so patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not being charged the full negotiated rate.
When reviewing your bill, be aware that hospitals may initially issue summary bills that obscure individual charges, making it difficult to identify errors or unbundled codes. Since over 80% of hospital bills contain errors, requesting a full itemized CPT-coded statement is the most effective way to verify that all services rendered were billed correctly and that no unnecessary charges were added. Additionally, while the Medicare amount for this service is $53.24, which serves as a benchmark for fair pricing, commercial rates can vary significantly based on contract terms. If you receive a balance bill for the difference between the provider's chargemaster rate and your insurance allowed amount, you may be protected under the No Surprises Act for emergency care or non-emergency services at in-network facilities, and you should dispute any unexpected bills in writing