Blood antibody screen
Facility: Girard Medical Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $45
- Cash Discount Price: $77
- vs. Medicare Baseline: 0.85x 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 | $45 - $226 | 85% |
| Blue Cross Blue Shield | $45 - $91 | 85% |
| Humana | $45 | 85% |
| Ambetter / Centene | $45 | 85% |
| Medicare (plans) | $45 | 85% |
| Kansas Superior Select-All Plans | $45 | 85% |
| UnitedHealthcare | $45 - $123 | 85% |
| Multiplan-All Plans | $119 | 224% |
| Uhhis-All Plans | $123 | 231% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT 86850) at Girard Medical Center in Girard, Kansas, the facility's cash median price is $77.00, which is lower than the state average of $129.00. While the facility's negotiated rates with major payers like Aetna and UnitedHealthcare range from $45 to $226, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. The facility, a Critical Access Hospital owned by a Government Hospital District, lists a cash median of $77.00 and a median negotiated amount of $45.00, suggesting that direct payment could be more cost-effective than relying on insurance for this specific service.
To avoid unexpected costs, patients should verify their plan's deductible status before scheduling, as some in-network rates may not apply until that threshold is met. If you choose to pay cash, ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the $77.00 cash median. Additionally, if you receive a bill that includes charges for services you did not receive or items that were cancelled, request a formal itemized audit to identify errors, as over 80% of hospital bills contain mistakes. Always ensure you are comparing rates against the Medicare benchmark of $53.24 rather than the inflated chargemaster list price to understand the true cost of care.