Hepatitis C antibody test
Facility: University Of Kansas Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $65
- Cash Discount Price: $18
- vs. Medicare Baseline: 4.56x 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 456% of the Medicare baseline (a markup of 356%). 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 |
|---|---|---|
| Larned State Hospital [503200090] | $19 - $274 | 133% |
| Health Plan Inc [503999941] | $30 - $437 | 210% |
| Accarent Health [503999034] | $32 - $465 | 224% |
| Alt Carelon Behavioral Health [503200905] | $32 - $465 | 224% |
| Allied National [503999937] | $38 - $558 | 266% |
| Php [503200005] | $38 - $687 | 266% |
| Med-Pay [503200040] | $39 - $563 | 273% |
| Healthlink [503200007] | $39 - $687 | 273% |
| Geha [503200036] | $39 - $563 | 273% |
| Inter-Americas Insurance [503999032] | $39 - $563 | 273% |
| Cerner [503200038] | $39 - $563 | 273% |
| Alt Wppa [5032000964] | $39 - $563 | 273% |
| Cigna | $41 - $744 | 287% |
| First Health [5032000110] | $42 - $613 | 294% |
| Aha-Healthcare Preferred [503200050] | $42 - $613 | 294% |
| Blue Cross Blue Shield | $44 - $714 | 308% |
| Correct Care Solutions [50311253] | $45 - $651 | 315% |
| Ascension Living Hope [503201517] | $45 - $651 | 315% |
| Consolidated Billing [50311256] | $45 - $651 | 315% |
| Coeur Plan Services [503301517] | $45 - $651 | 315% |
| Orscheln Industries [503201608] | $48 - $698 | 336% |
| Empire Plan/Nyship [503200705] | $49 - $714 | 343% |
| Alt Lucent Health Solutions [503202603] | $49 - $714 | 343% |
| Alt Lineco [5032000976] | $49 - $714 | 343% |
| Century Health Solutions [503200054] | $51 - $744 | 357% |
| Quiktrip [5032000412] | $51 - $744 | 357% |
| Point Comfort Underwriters [503200018] | $51 - $744 | 357% |
| Meritain Health [503200039] | $54 - $781 | 378% |
| Wppa [503200056] | $54 - $781 | 378% |
| Employers Health Network [503999025] | $58 - $837 | 406% |
| Plan Care America [503999026] | $58 - $837 | 406% |
| Sanford Health Plan [503999027] | $58 - $837 | 406% |
| Usa Managed Care [503999030] | $58 - $837 | 406% |
| Three Rivers Provider Network [503999029] | $58 - $837 | 406% |
| Workers Comp [503999901] | $61 - $884 | 427% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at University Of Kansas Hospital, the cash price of $18.00 is significantly lower than the facility's gross charge of $91.00 and the median negotiated rate of $65.00 paid by insurance plans. While the facility's cash rate is higher than the state average of $14.27 (Medicare benchmark), it remains substantially below the wide range of negotiated rates observed across payers, which span from $19 to $884. Patients with high-deductible plans may find the cash price advantageous if their insurance negotiated rate exceeds $18.00, as paying out-of-pocket could result in immediate savings compared to the administrative costs and potential balance billing associated with insurance claims.
To ensure you receive the most accurate pricing, it is essential to request a prompt-pay discount or self-pay rate directly from the hospital before scheduling, as these upfront discounts can further reduce the cost below the listed cash price. If you are using insurance, be aware that while the facility is in-network for many plans, the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, though you should still verify your specific plan's allowed amount to avoid unexpected charges. Finally, if you receive a bill, always demand a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.