Blood antibody screen
Facility: Children'S Mercy South
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $134
- Cash Discount Price: $99
- vs. Medicare Baseline: 2.52x 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 252% of the Medicare baseline (a markup of 152%). 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 | $9 - $138 | 17% |
| Healthy Blue | $9 - $135 | 17% |
| Medicaid / KanCare | $10 | 19% |
| Blue Cross Blue Shield | $84 - $152 | 158% |
| Cigna | $99 - $143 | 186% |
| Home State Health | $118 | 222% |
| Medica | $120 | 225% |
| Aetna | $124 - $140 | 233% |
| Quiktrip | $134 | 252% |
| Orscheln | $134 | 252% |
| Nebraska Furniture Mart | $134 | 252% |
| Health Midwest Comprehensive Care | $134 | 252% |
| Wppa Providrs Care | $134 | 252% |
| Wellfit/Centrus | $134 | 252% |
| Centivo | $134 | 252% |
| Humana | $137 | 257% |
| Coventry Health Care Of Kansas | $152 | 285% |
| Coxhealth Network | $152 | 285% |
| Mercy Health | $154 | 289% |
| Multiplan | $157 | 295% |
| American Healthcare Alliance | $175 | 329% |
| Healthlink | $181 | 340% |
| National Preferred Provider Network | $185 | 347% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, "Blood antibody screen," Children's Mercy South in Overland Park, KS, lists a gross charge of $206.00. While the facility offers a cash price of $99.00, which is lower than the state average of $134.00, commercial insurance plans typically pay significantly higher negotiated rates, ranging from $9 to $185 depending on the carrier. For instance, UnitedHealthcare and Healthy Blue pay between $9 and $138, whereas larger networks like Blue Cross Blue Shield and Cigna pay between $84 and $152. Patients with high-deductible plans may find the cash price of $99.00 more cost-effective than their insurance allowed amounts, which often exceed the cash rate due to administrative overhead and contract dynamics.
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, unexpected charges can still occur if ancillary services are billed separately. To minimize costs, patients should request an itemized bill to verify that all charges correspond to services actually rendered and to identify any unbundled codes. Additionally, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can often reduce the final amount owed. If a patient receives a bill that appears inflated or contains errors, they should dispute it in writing rather than accepting a summary invoice, ensuring they are not paying for services not received or double-billed items.