Hepatitis C antibody test
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $66
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Smarthealth | $13 - $20 | 91% |
| Medicare (plans) | $14 - $15 | 98% |
| Providrs Care | $14 | 98% |
| UnitedHealthcare | $14 - $40 | 98% |
| Humana | $14 | 98% |
| Va | $14 | 98% |
| Aetna | $15 | 105% |
| Medicaid / KanCare | $15 | 105% |
| Ambetter / Centene | $24 | 168% |
| Blue Cross Blue Shield | $130 - $158 | 911% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Ascension Via Christi Hospital Manhattan, Inc, the cash median price is $66.00, which is significantly lower than the facility's gross charge of $164.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield range from $130 to $158, these amounts often exceed the cash price, making self-pay a potentially more affordable option for patients with high-deductible plans who have not yet met their coverage thresholds. It is important to note that commercial negotiated rates frequently include administrative overhead and do not represent the true cost of care; comparing these rates to the Medicare benchmark of $14.27 reveals a substantial markup, whereas the cash rate aligns much closer to the actual cost basis.
Patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling services, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly insurance billing cycles. If you receive a bill after insurance processing, you should demand a full itemized audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. Additionally, under federal protections like the No Surprises Act, you are generally shielded from balance billing for out-of-network services at in-network facilities, so any unexpected charges should be disputed immediately with your insurer rather than paid out of pocket to avoid unnecessary debt.