Blood antibody screen
Facility: Salina Regional Health Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $120
- Cash Discount Price: $109
- vs. Medicare Baseline: 2.25x 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 225% of the Medicare baseline (a markup of 125%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $13 - $14 | 24% |
| Preferred Phsic | $78 - $129 | 147% |
| Preferred Healthcare - All Other Plans | $106 - $174 | 199% |
| Aetna | $117 - $194 | 220% |
| Providers Care (Wppa)-All Plans | $117 - $194 | 220% |
| Cigna | $117 - $194 | 220% |
| Multiplan (Mpi)-All Plans | $117 - $194 | 220% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT code 86850) at Salina Regional Health Center in Salina, Kansas, the facility's cash median rate is $109.00, which is lower than the state average of $120.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Preferred Phsic range from $13 to $194, these amounts often exceed the cash price. For patients with high-deductible plans or those without insurance, paying the cash rate of $109.00 directly can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the deductible has not yet been met. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the total cost.
It is important to understand that commercial insurance rates are often inflated by administrative overhead and contract dynamics, sometimes reaching 200% to 300% of the Medicare benchmark rate of $53.24 for this service. The facility's negotiated rates average $120.00, which is 2.3 times the Medicare amount, illustrating the significant markup common in commercial billing. If you receive a bill that includes charges for out-of-network services at this in-network facility, you may be subject to balance billing for the difference between the provider's full charge and your insurance allowed amount. However, the No Surprises Act protects patients from such surprise bills for emergency care and non-emergency services at in-network hospitals. To ensure accuracy, always request a full itemized bill before paying, as summary invoices