Hepatitis C antibody test
Facility: Providence Medical Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $15
- Cash Discount Price: $14
- 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 |
|---|---|---|
| Midland Care Connection | $14 | 98% |
| UnitedHealthcare | $14 - $24 | 98% |
| Cigna | $14 | 98% |
| Blue Cross Blue Shield | $14 - $34 | 98% |
| Medicare (plans) | $14 | 98% |
| Medicaid / KanCare | $14 | 98% |
| Tricare | $14 | 98% |
| Aetna | $14 - $25 | 98% |
| Kansas Superior Select | $15 | 105% |
| Celtic | $15 - $23 | 105% |
| Healthy Blue | $15 | 105% |
| Corizon | $19 | 133% |
| Well Path Prison | $20 | 140% |
| Employer Direct Healthcare | $20 | 140% |
| Centurion | $21 | 147% |
| Naphcare | $22 | 154% |
| Comp Alliance - Fka Compresults Worker Compensation | $29 | 203% |
| Oha Networks | $31 | 217% |
| Worker Compensation | $32 | 224% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Providence Medical Center in Kansas City, KS, the facility's cash median rate of $14.00 is significantly lower than the state average of $45.00, making it a potentially cost-effective option for patients with high-deductible plans or those paying out-of-pocket. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $14 to $34, these amounts often exceed the cash price, illustrating that commercial insurance contracts can sometimes result in higher costs than self-pay. To maximize savings, patients should verify their specific plan's allowed amount and inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative fees associated with insurance claims.
Pricing transparency for this service shows a stark contrast between the facility's gross charge of $118.00 and the actual amounts paid by insurers, which average between $14 and $34 depending on the carrier. This gap highlights the importance of comparing rates against the Medicare benchmark of $14.27, which serves as a scientifically validated baseline for the true cost of care rather than the inflated hospital chargemaster. Although the facility is a voluntary non-profit church-owned hospital, patients should avoid accepting summary bills that obscure individual line items, as an itemized audit is the most effective way to identify errors, unbundled codes, or services not rendered. Furthermore, since the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients can confidently dispute any unexpected charges without fear of credit damage