Blood antibody screen
Facility: Northeast Regional Medical Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $125
- Cash Discount Price: $130
- vs. Medicare Baseline: 2.35x 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 235% of the Medicare baseline (a markup of 135%). 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 |
|---|---|---|
| Veterans Eval Services | $10 | 19% |
| Medicaid / KanCare | $46 - $74 | 86% |
| Node Champva | $53 | 100% |
| Tricare | $53 | 100% |
| Medicare (plans) | $55 | 103% |
| Node VA | $56 | 105% |
| UnitedHealthcare | $56 - $247 | 105% |
| Blue Cross Blue Shield | $56 - $100 | 105% |
| Node Hospice Non Par Agree | $56 | 105% |
| Node Devoted Health McR Adv | $58 | 109% |
| Blue Pathway/Pathway X | $65 | 122% |
| Centurion Correctional | $70 | 131% |
| Us Department of Labor | $70 | 131% |
| Self Pay | $79 - $181 | 148% |
| Home State Exchange | $101 | 190% |
| Naphcare | $106 | 199% |
| Cigna | $112 - $129 | 210% |
| Immergrun | $112 | 210% |
| Aetna | $122 - $274 | 229% |
| Blue Prefrerred | $135 | 254% |
| Blue Access | $139 | 261% |
| Access Health Services, LLC | $214 | 402% |
| Healthlink | $247 - $263 | 464% |
| Multiplan | $247 - $263 | 464% |
| Coventry Wc | $263 | 494% |
Consumer Guidance & Cost Commentary
For the CPT code 86850, Blood antibody screen, Northeast Regional Medical Center in Kirksville, Missouri, lists a cash median rate of $130. This facility is a Proprietary Acute Care Hospital located at 315 S Osteopathy with a facility rating of 2. While the cash price is available, patients should note that Medicare allows a payment of $53.24 for this service, and the facility's median negotiated rate is $125. Given that the cash rate is higher than the Medicare benchmark (a ratio of 2.3), patients with high-deductible plans or those who have already met their out-of-pocket maximum may find the cash price more predictable than navigating insurance networks where administrative costs can inflate the baseline price by 20% to 40%.
To maximize financial savings, consumers are advised to verify if the facility offers a prompt-pay discount, which can range from 20% to 50% off the billed amount for upfront payment, effectively bypassing the costly claims processing cycle. It is crucial to understand that assuming an in-network rate is always the best price is a common pitfall; in this case, the negotiated rate of $125 is higher than the cash option of $130 only slightly, but commercial payer rates vary significantly, with UnitedHealthcare ranging from $56 to $247 and Aetna from $122 to $274. Before scheduling, patients should request a waiver of insurance submission to secure the cash rate and avoid potential balance billing, especially since the No Surprises Act protects against unexpected out-of-network charges for services at in-network facilities.