Blood antibody screen
Facility: Centura St. Catherine-Dodge City
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $115
- Cash Discount Price: $70
- vs. Medicare Baseline: 2.16x 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 216% of the Medicare baseline (a markup of 116%). 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 |
|---|---|---|
| Kansas Health | $10 | 19% |
| Humana | $10 | 19% |
| Aetna | $10 - $139 | 19% |
| Kaiser | $10 | 19% |
| Cigna | $10 | 19% |
| Medicare (plans) | $10 | 19% |
| Blue Cross Blue Shield | $10 - $107 | 19% |
| Centura Employee Plan | $13 | 24% |
| UnitedHealthcare | $115 | 216% |
| Wpaa | $122 | 229% |
| Christian Health Aid | $139 | 261% |
| Multiplan | $139 - $157 | 261% |
| Health Partners Of Kansas | $157 | 295% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, representing a blood antibody screen, the facility's cash median price is $70.00, which is significantly lower than the state average of $115.00. While many commercial payers negotiate rates ranging from $10 to $157, the cash price remains the most affordable option for patients without insurance or those with high-deductible plans. Because the negotiated rates often exceed the cash price, patients with significant deductibles may save money by paying out-of-pocket and then seeking reimbursement from their insurer, provided the service is covered. It is crucial to verify your specific plan's coverage and deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in substantial out-of-pocket costs.
To ensure you are receiving the most accurate billing, always request an itemized bill that lists every specific CPT code and charge rather than accepting a summary invoice. This practice helps identify potential errors, such as unbundled services or charges for items not rendered, which are common in hospital billing. Additionally, if you are self-paying, ask the facility about prompt-pay discounts, which can reduce the total amount due by 20% to 50% if settled within 30 days. These discounts bypass the administrative costs associated with insurance claims processing, offering a direct reduction in your final bill. Always confirm the self-pay classification at registration to prevent automatic claims submission, which could void any cash discount agreements.