Hepatitis C antibody test
Facility: Salina Regional Health Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $115
- Cash Discount Price: $89
- vs. Medicare Baseline: 8.06x 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 $14.27 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 806% of the Medicare baseline (a markup of 706%). 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 | $28 - $30 | 196% |
| Preferred Phsic | $76 | 533% |
| Preferred Healthcare - All Other Plans | $103 | 722% |
| Multiplan (Mpi)-All Plans | $115 | 806% |
| Cigna | $115 | 806% |
| Providers Care (Wppa)-All Plans | $115 | 806% |
| Aetna | $115 | 806% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Salina Regional Health Center in Salina, Kansas, the facility's cash median price of $89.00 is notably lower than the state average of $103.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield, Cigna, and Aetna range from $28 to $115, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $89.00. It is important to note that the facility's cash rate is also higher than the Medicare benchmark of $14.27, which serves as the federal baseline for cost evaluation.
To ensure you are not overcharged, always request an itemized bill before paying, as summary invoices can obscure individual service costs. If you receive a balance bill for out-of-network services, remember that the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency care and non-emergency services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce your total cost by 20% to 50% if you settle the account in full upfront, bypassing the administrative fees associated with insurance claims processing.