Blood antibody screen
Facility: Wamego Health Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $10
- Cash Discount Price: $57
- vs. Medicare Baseline: 0.19x 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 |
|---|---|---|
| UnitedHealthcare | $8 | 15% |
| Aetna | $9 | 17% |
| Medicaid / KanCare | $9 | 17% |
| Providrs Care | $10 | 19% |
| Tricare | $18 | 34% |
| Blue Cross Blue Shield | $121 - $131 | 227% |
Consumer Guidance & Cost Commentary
For the blood antibody screen (CPT 86850) at Wamego Health Center in Wamego, KS, the facility's cash median price is $57.00, which is significantly lower than the state average of $142.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range between $8.00 and $9.00, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. The facility also offers a median negotiated rate of $10.00 for Medicaid/KanCare plans, but patients should verify their specific plan details, as some commercial policies may not cover this service or may require the patient to meet a deductible before coverage begins.
It is important to note that the facility's cash rate is substantially below the gross chargemaster price of $142.00, reflecting a significant discount for self-pay patients. If you are self-insured or have a high-deductible plan, you may qualify for a prompt-pay discount by paying the full amount upfront, which can further reduce the cost. Additionally, if you are receiving emergency care or have out-of-network ancillary services, the No Surprises Act protects you from balance billing for those specific services, though you should still request an itemized bill to ensure no errors exist. Always ask the billing department about self-pay or prompt-pay discounts before scheduling to ensure you are receiving the most favorable rate available.