Blood antibody screen
Facility: Smith County Memorial Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $31
- Cash Discount Price: $33
- vs. Medicare Baseline: 0.58x 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 |
|---|---|---|
| Blue Cross Blue Shield | $21 | 39% |
| Medicaid / KanCare | $23 - $33 | 43% |
| Multiplan-All Plans | $30 | 56% |
| Health Partners Of Ks Ppo-All Plans | $31 | 58% |
| Wppa-All Plans | $31 | 58% |
| UnitedHealthcare | $31 | 58% |
| Midlands Choice-All Plans | $31 | 58% |
Consumer Guidance & Cost Commentary
For this blood antibody screen service at Smith County Memorial Hospital in Smith Center, KS, the cash price is $33.00, which matches the facility's gross chargemaster rate. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $21.00 to $33.00, the cash price remains competitive and aligns with the median paid amount of $30.00. It is important to note that for patients with high-deductible plans, paying the cash price of $33.00 upfront can sometimes be more cost-effective than using insurance, as the negotiated rates for some commercial payers exceed the cash price. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which could further reduce the final bill if payment is made in full within a specific timeframe.
When evaluating this rate, it is crucial to compare it against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this procedure is $53.24, meaning the cash price of $33.00 represents a significant discount relative to the federal baseline, falling well below the typical commercial markup range of 200% to 300% of Medicare. If you have received a bill from this facility, you should request a detailed, itemized CPT-coded statement to ensure no errors, such as unbundled codes or charges for services not rendered, have inflated your total. Since over 80% of hospital bills contain errors, reviewing the line items before paying is the most effective way to avoid unnecessary debt.