Hepatitis C antibody test
Facility: Wesley Medical Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $31
- Cash Discount Price: $789
- vs. Medicare Baseline: 2.17x 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 217% of the Medicare baseline (a markup of 117%). 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 |
|---|---|---|
| Coventry Health Care | $14 | 98% |
| Aetna | $14 - $282 | 98% |
| United | $14 - $355 | 98% |
| UnitedHealthcare | $14 | 98% |
| Humana | $14 | 98% |
| Devoted Health | $14 | 98% |
| Ambetter / Centene | $15 - $142 | 105% |
| Medicaid / KanCare | $15 | 105% |
| Triwest Health Alliance | $15 | 105% |
| Amerigroup | $15 | 105% |
| Correct Care Solutions | $21 | 147% |
| First Health | $30 - $364 | 210% |
| Multiplan | $31 - $710 | 217% |
| Blue Cross Blue Shield | $43 | 301% |
| Health Partners Of Kansas | $136 - $394 | 953% |
| Wppa | $137 | 960% |
| Medical Associates Health Plan | $149 | 1044% |
| Preferred Health Choices | $149 | 1044% |
| Spirit Aerosystems | $252 | 1766% |
| Triwest Healthcare Alliance | $513 | 3595% |
| Usa Managed Care | $671 | 4702% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Wesley Medical Center in Wichita, KS, the cash price is $789.00, which matches the facility's cash median. While the facility's negotiated rates range from $14 to $671 across 21 payers, the cash price is notably higher than the median negotiated rate of $31.00 and significantly exceeds the Medicare benchmark of $14.27. Because commercial insurance contracts often include administrative overheads that inflate rates, paying cash upfront can sometimes result in a lower total cost for patients with high-deductible plans, provided the insurance negotiated rate exceeds the cash price. Patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may still result in higher out-of-pocket costs than self-pay options.
To ensure you are not overcharged, it is important to understand that hospitals may issue summary bills that obscure individual line items, so always request a full itemized CPT-coded statement before agreeing to pay. Additionally, if you receive a balance bill for services rendered at an in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers. Before finalizing payment, contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window. Given that over 80% of hospital bills contain errors, disputing any discrepancies in writing with a certified letter to the billing supervisor is the most effective way to reduce medical debt.