Blood antibody screen
Facility: Amberwell Atchison Association
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $271
- Cash Discount Price: $603
- vs. Medicare Baseline: 5.09x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 509% of the Medicare baseline (a markup of 409%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $54 - $1,082 | 101% |
| Blue Cross Blue Shield | $87 - $91 | 163% |
| Superior Select Mcr Adv - All Plans | $199 | 374% |
| Triwest - All Plans | $199 | 374% |
| Humana | $199 - $271 | 374% |
| Va Ccn - All Plans | $199 | 374% |
| Ambetter / Centene | $308 | 579% |
| Cigna | $332 | 624% |
| Aetna | $332 | 624% |
| Oscar - All Plans | $452 | 849% |
| Centrus Health Direct - All Plans | $452 | 849% |
| Multiplan - All Plans | $470 | 883% |
| Wppa Providrs Care - All Plans | $543 | 1020% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Amberwell Atchison Association in Atchison, KS, lists a cash median price of $603.00, which matches the facility's gross charge. This cash rate is significantly higher than the state average, as indicated by the 5.1% variance versus Medicare. While commercial payers negotiate rates ranging from $54 to $543 depending on the plan, patients with high-deductible plans might find the cash price more affordable if their insurance negotiated rate exceeds $603.00. It is important to note that the cash median is not necessarily the lowest possible cost; many facilities offer "self-pay" or "prompt-pay" discounts that can reduce the final amount owed.
Patients should avoid accepting summary bills that only show broad categories like "Laboratory" and instead request a detailed, itemized CPT-coded statement to identify any errors, unbundled charges, or services not rendered, as over 80% of hospital bills contain mistakes. When comparing costs, it is more accurate to look at the Medicare benchmark of $53.24 rather than the facility's inflated chargemaster list, which can make discounts appear larger than they are. Additionally, while the facility is in-network for many plans, patients must verify their specific deductible status before scheduling, as paying the negotiated rate without meeting the deductible can result in higher out-of-pocket expenses than paying cash upfront.