Blood antibody screen
Facility: Fredonia Regional Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $76
- Cash Discount Price: $84
- vs. Medicare Baseline: 1.43x 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 - $76 | 15% |
| Blue Cross Blue Shield | $42 - $91 | 79% |
| Veterans Programs - All Plans | $43 | 81% |
| Aetna | $43 - $76 | 81% |
| Cigna | $76 | 143% |
| Reserve National-All Plans | $76 | 143% |
| Meritain-All Plans | $76 | 143% |
Consumer Guidance & Cost Commentary
For this blood antibody screen procedure at Fredonia Regional Hospital in Kansas, the cash price is $84.00, which matches the facility's median negotiated rate of $76.00 and the cash median. While the facility is a Critical Access Hospital owned by the local government, the data indicates that insurance negotiated rates for this service can vary significantly, ranging from $8 to $91 across different payers. It is important to note that for patients with high-deductible plans, paying the cash price of $84.00 upfront may be more cost-effective than relying on insurance, as some commercial payers negotiate rates that exceed the cash price. Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
When reviewing your bill, be aware that commercial insurance rates are often higher than the Medicare benchmark of $53.24 due to administrative costs and contract dynamics. The facility's cash rate of $84.00 is approximately 1.4 times the Medicare amount, reflecting the standard markup found in commercial pricing. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be facing balance billing, where the provider bills you for the difference between the full chargemaster rate and what your insurance allowed. To protect yourself, always request a detailed, itemized bill before paying, as summary bills can obscure errors or unbundled charges. If you receive a surprise bill, you have the right to dispute it under the No Surprises Act and should never sign away your rights to contest out-of-network costs without fully understanding the