CMS Price Transparency Data

Hepatitis C antibody test

Facility: St. Catherine Hospital - Garden City

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $44
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 3.08x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St. Catherine Hospital - Garden City is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.08x the Medicare baseline. Located in 401 East Spruce, Garden City, KS.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14.27 (100%)
Cash / Self-Pay: $63 (441%)
Insurance Median: $44 (308%)
Cash: $63 (441% of Medicare)
Ins. Median: $44 (308% of 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 308% of the Medicare baseline (a markup of 208%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Innovage $14 98%
Aetna $14 - $108 98%
Devoted Health $14 98%
UnitedHealthcare $14 - $79 98%
Blue Cross Blue Shield $14 - $53 98%
Kansas Health $14 98%
Humana $14 98%
Medicare (plans) $14 98%
Kaiser $14 - $51 98%
Cigna $14 - $19 98%
Centura Employee Plan $18 126%
United Colorado Doctor'S Plan $21 147%
Direct To Employer $25 - $74 175%
Denver Health $44 308%
Peak Health $72 505%
Wpaa $90 631%
Christian Health Aid $103 722%
Multiplan $116 - $157 813%
Health Partners Of Kansas $124 869%

Consumer Guidance & Cost Commentary

For the Hepatitis C antibody test (CPT 86803), St. Catherine Hospital - Garden City in Garden City, KS, lists a cash median price of $63.00 and a median negotiated rate of $44.00 across 19 payers. This cash price is significantly lower than the facility's Medicare benchmark of $14.27, which serves as the federal baseline for cost. While the facility is a voluntary non-profit church-owned acute care hospital, patients should note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. For individuals with high-deductible plans, paying the cash price of $63.00 upfront may be more cost-effective than relying on insurance, especially since the median negotiated rate of $44.00 represents a ceiling that can still result in higher out-of-pocket costs if the patient's deductible has not been met.

To ensure you are receiving the most accurate pricing, it is critical to request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you choose to pay out-of-network or encounter unexpected charges, the No Surprises Act provides federal protections against balance billing for emergency care and non-emergency services at in-network facilities. Additionally, patients should inquire about prompt-pay discounts, which can reduce bills by 20% to 50% when paid in full within 30 days, bypassing the costly claims processing cycle. Always verify your specific plan details with the hospital before scheduling to confirm whether your insurance will apply the negotiated rate or if the cash price offers the best financial outcome

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 East Spruce, Garden City, KS 67846
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals