Hepatitis C antibody test
Facility: Lmh
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $15
- Cash Discount Price: $75
- vs. Medicare Baseline: 1.05x 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 |
|---|---|---|
| UnitedHealthcare | $13 - $46 | 91% |
| Blue Cross Blue Shield | $13 - $194 | 91% |
| Humana | $14 | 98% |
| Medicare (plans) | $14 | 98% |
| Cigna | $14 - $200 | 98% |
| Haskell Indian Health Services | $14 | 98% |
| Allwell | $15 | 105% |
| Aetna | $16 - $248 | 112% |
| Ambetter / Centene | $22 | 154% |
| Non Contracted | $239 | 1675% |
| First Health | $278 | 1948% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test (CPT 86803), the facility's cash price of $75.00 is significantly lower than the state average of $14.27 for Medicare reimbursement, though the cash rate itself exceeds the median negotiated rate of $15.00 observed across payers. While commercial insurance plans like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $13 to $248, patients with high-deductible plans may find the $75 cash price more affordable if their insurance allowed amount exceeds this figure. It is important to note that the cash price is not the same as the Medicare amount; comparing your specific insurance allowed amount to the $75 cash rate can reveal potential savings, and you should always ask the hospital about self-pay or prompt-pay discounts before scheduling to ensure you are receiving the lowest possible rate.
This service is provided at Lmh, an Acute Care Hospital in Lawrence, KS, which is owned by the Government - Local and holds a facility rating of 4. The data reflects the 2026-06 vintage, showing that while some payers like Aetna and Cigna have wide negotiated ranges extending up to $248, others such as Humana and Medicare have fixed rates of $14.27. Because commercial rates often include administrative overhead and vary by contract, the cash price serves as a useful benchmark for determining if your specific insurance plan is charging a premium. If you receive a bill that appears higher than expected, you should request an itemized audit to verify that no unbundled codes or services not rendered are included, as over 80% of hospital