Blood antibody screen
Facility: Kingman Healthcare Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $8
- Cash Discount Price: $17
- vs. Medicare Baseline: 0.15x 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 |
|---|---|---|
| Medicaid / KanCare | $2 - $28 | 4% |
| Ambetter / Centene | $2 - $28 | 4% |
| Humana | $2 - $25 | 4% |
| Celtic Insurance Company | $2 - $28 | 4% |
| Wellcare | $2 - $25 | 4% |
| UnitedHealthcare | $2 - $57 | 4% |
| Cigna | $4 - $57 | 8% |
| Aetna | $4 - $57 | 8% |
| Health Partners | $4 - $57 | 8% |
| Healthy Blue | $8 | 15% |
| Triwest | $16 | 30% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Kingman Healthcare Center in Kingman, KS, lists a cash median price of $17.00, which is significantly lower than the Medicare benchmark of $53.24. This facility, a Critical Access Hospital, reports a negotiated rate of $8.00, which is notably lower than both the Medicare amount and the cash price. While commercial payers like Medicaid/KanCare and UnitedHealthcare have negotiated rates ranging from $2 to $28, the cash rate of $17.00 represents a substantial discount compared to the federal baseline. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates for many commercial plans exceed the cash-pay amount, and hospitals often offer additional self-pay or prompt-pay discounts for upfront payment.
The facility's pricing structure highlights the difference between commercial contracts and federal benchmarks. Although commercial payers such as Cigna and Aetna have negotiated rates that can reach up to $57, the cash price of $17.00 serves as a transparent floor for patients. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details before scheduling. To ensure the most accurate pricing, consumers are encouraged to request an itemized bill to review specific CPT codes and avoid summary bills that may obscure individual charges. Given that the cash rate is well below the Medicare benchmark, paying out-of-pocket or utilizing a prompt-pay discount could result in lower overall costs than the standard insurance negotiated rates.