Blood antibody screen
Facility: Morris County Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $70
- Cash Discount Price: $82
- vs. Medicare Baseline: 1.31x 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 | $10 | 19% |
| Providrs Care (Wppa)(Nexus)-All Plans | $10 | 19% |
| Va Ccn-All Plans | $13 | 24% |
| UnitedHealthcare | $53 - $136 | 100% |
| Blue Cross Blue Shield | $53 - $91 | 100% |
| Choice Care Mcr Adv-All Plans | $53 | 100% |
| Coventry Mcr | $53 | 100% |
| Cigna | $98 | 184% |
| Coventry Comm-All Other Plans | $122 | 229% |
| Multiplan-All Plans | $122 | 229% |
Consumer Guidance & Cost Commentary
For this blood antibody screen at Morris County Hospital in Council Grove, Kansas, the facility's cash price of $82.00 is notably lower than the state average of $136.00, offering a potential savings of $54.00 for patients paying out-of-pocket. While the hospital's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $53.00 to $91.00, these amounts often exceed the cash price, meaning self-pay patients may save money by choosing to pay directly. It is important to note that cash payments can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate is higher than the cash price, so verifying the specific allowed amount with the hospital before scheduling is essential. Additionally, patients should explicitly ask about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if paid in full upfront.
The facility's Medicare benchmark of $53.24 serves as a critical baseline for evaluating pricing fairness, as commercial rates are often significantly higher than this federal standard. In this case, the cash price of $82.00 represents a markup of approximately 53% over the Medicare rate, which aligns with fair pricing expectations rather than the inflated chargemaster lists that can mislead consumers. If you receive a bill that includes unexpected charges beyond the negotiated or cash rate, you may be facing balance billing, which is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. To ensure you are not overcharged, request a full itemized audit of your statement to identify any unbundled codes or services