Blood antibody screen
Facility: Ascension Via Christi Rehabilitation Hospital Inc
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $50
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.94x 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 |
|---|---|---|
| Smarthealth | $7 - $69 | 13% |
| Aetna | $13 - $31 | 24% |
| Cigna | $15 | 28% |
| Vc Hope | $49 | 92% |
| Va | $49 | 92% |
| Medicare (plans) | $49 - $50 | 92% |
| Humana | $49 | 92% |
| UnitedHealthcare | $50 - $138 | 94% |
| Blue Cross Blue Shield | $50 | 94% |
| Medicaid / KanCare | $84 | 158% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," at Ascension Via Christi Rehabilitation Hospital Inc in Wichita, KS, the facility's negotiated rates range from $7 to $138 across ten different payers. While the median negotiated amount is $50.00, this figure varies significantly depending on the specific insurance plan, with rates as low as $7 for Smarthealth and as high as $138 for UnitedHealthcare. It is important to note that these negotiated rates often exceed the actual cost of care due to administrative overhead and contract dynamics; for instance, commercial rates can average 200% to 300% of the Medicare benchmark of $53.24 for this service. Patients should be aware that being in-network does not guarantee the lowest possible price, as different insurers have distinct contract ceilings that may result in higher allowed amounts than what a self-pay patient would encounter.
To potentially lower out-of-pocket costs, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as hospitals often offer fee reductions of 20% to 50% for upfront payment that bypasses the costly insurance claims process. Additionally, because cash prices are frequently lower than commercial negotiated rates, individuals with high-deductible plans might find it financially advantageous to pay the cash price directly, especially if their insurance allowed amount exceeds the facility's cash rate. Before finalizing any payment, it is recommended to request a full itemized bill to verify that no unbundled codes or services not rendered have inflated the total, ensuring that the final charge aligns with the transparent data provided.