Hepatitis C antibody test
Facility: Labette Health
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $26
- Cash Discount Price: $35
- vs. Medicare Baseline: 1.82x 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.
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 |
|---|---|---|
| Montgomery County | $13 - $59 | 91% |
| Wellcare | $14 | 98% |
| Humana | $14 | 98% |
| Medicaid / KanCare | $14 - $15 | 98% |
| Blue Cross Blue Shield | $14 - $45 | 98% |
| Multiplan | $14 - $151 | 98% |
| UnitedHealthcare | $14 - $155 | 98% |
| Healthy Blue | $15 | 105% |
| Uhccp | $16 | 112% |
| Ambetter / Centene | $16 | 112% |
| Choicecare (First Health Network) | $51 - $160 | 357% |
| Health Partners Of Kansas, Inc | $51 - $160 | 357% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Labette Health in Parsons, KS, the cash price of $35.00 is significantly lower than the facility's gross charge of $50.00. This cash rate is also notably lower than the state average for this service, which sits at $59.00. While many insurance plans have negotiated rates ranging from $13.00 to $160.00, patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, as the negotiated rates for some payers exceed the cash amount. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill.
The facility's cash rate of $35.00 is higher than the Medicare benchmark of $14.27, reflecting a markup common in commercial pricing structures. However, the median negotiated rate across all payers is $26.00, which is lower than the cash price, suggesting that for those with active insurance coverage, the allowed amount may be more favorable. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and deductible status before proceeding. If a patient receives a large post-service bill, they should request a full itemized statement to review all CPT codes and ensure no unbundled charges or errors are present before making any payment.