Hepatitis C antibody test
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $94
- Cash Discount Price: $69
- vs. Medicare Baseline: 6.59x 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 659% of the Medicare baseline (a markup of 559%). 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 |
|---|---|---|
| Aetna | $94 | 659% |
| Black Lung [6055] | $94 | 659% |
| Oncology Patient Assistance Programs [2295] | $94 | 659% |
| Blue Cross Blue Shield | $94 | 659% |
| Healthcare Highways [2210] | $94 | 659% |
| Web Tpa [2115] | $94 | 659% |
| Hooray Health [8000] | $94 | 659% |
| Lucent Health [6000] | $94 | 659% |
| Department Of Corrections [1340] | $115 | 806% |
| Cigna | $132 | 925% |
| American Postal Workers Union [1070] | $132 | 925% |
| Healthpartners [1500] | $132 | 925% |
| National Association Of Letter Carriers [1695] | $132 | 925% |
| Humana | $135 | 946% |
| American Healthcare [1055] | $178 | 1247% |
| First Health [1375] | $178 | 1247% |
| Multiplan [1680] | $178 | 1247% |
| Administrative Concepts [1005] | $178 | 1247% |
| Coventry Healthcare [1320] | $188 | 1317% |
| Ks Disability Determination [6090] | $229 | 1605% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at the University of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rate is $94.00, which is significantly lower than the state average of $132.00. While the facility's gross charge is $229.00, the median negotiated rate across 20 payers is $94.00, and the cash median price is $69.00. This indicates that paying cash directly could result in a lower out-of-pocket cost compared to using insurance, as the cash price is already below the facility's negotiated rate. Patients with high-deductible plans should consider asking the hospital about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
The facility's pricing is also benchmarked against Medicare, with a rate of $14.27, showing that the cash price of $69.00 represents a substantial markup over the federal baseline. Although the facility is a voluntary non-profit church-owned hospital, the commercial negotiated rates remain higher than the cash option due to the administrative costs associated with insurance billing cycles. To ensure you are not overcharged, it is advisable to request a full itemized bill before payment and verify that no balance billing occurs for out-of-network ancillary services, as federal protections under the No Surprises Act may apply. Always confirm your specific plan's allowed amount with the billing department, as individual payer contracts can vary even within the same network.