Blood antibody screen
Facility: Bob Wilson Memorial Hospital
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $88
- Cash Discount Price: $42
- vs. Medicare Baseline: 1.65x 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 |
|---|---|---|
| Centura Employee Plan | $13 | 24% |
| Aetna | $34 - $84 | 64% |
| Kansas Health | $34 | 64% |
| Medicare (plans) | $34 | 64% |
| UnitedHealthcare | $34 - $88 | 64% |
| Humana | $34 | 64% |
| Multiplan | $95 - $98 | 178% |
| Health Partners Of Kansas | $99 | 186% |
| Wppa | $100 | 188% |
| Blue Cross Blue Shield | $122 | 229% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Bob Wilson Memorial Hospital in Ulysses, KS, lists a gross charge of $105.00. When compared to the Medicare benchmark of $53.24, the facility's gross rate is 1.7 times higher, indicating a significant markup above the federal cost baseline. While the hospital offers a negotiated rate of $88.00 for in-network patients, this amount remains higher than the cash median of $42.00. In many cases, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rate often exceeds the cash price due to administrative overheads. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total cost by 20% to 50%.
The data reflects pricing across ten different payers, with negotiated amounts ranging from $13.00 for Centura Employee Plan to $122.00 for Blue Cross Blue Shield. It is important to note that the median negotiated rate of $88.00 does not represent a single universal price; rather, it is an average across multiple insurance plans, some of which may have significantly lower allowed amounts. Patients should verify their specific plan's allowed amount before receiving care to avoid unexpected balance billing, although the No Surprises Act generally protects against surprise bills for emergency services at in-network facilities. Since this facility is a Critical Access Hospital owned by a voluntary non-profit church, patients are encouraged to contact the billing department directly to confirm if any additional discounts are