Hepatitis C antibody test
Facility: Centura St. Catherine-Dodge City
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $318
- Cash Discount Price: $193
- vs. Medicare Baseline: 22.28x 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 2228% of the Medicare baseline (a markup of 2128%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $14 - $53 | 98% |
| Medicare (plans) | $14 | 98% |
| Kaiser | $14 | 98% |
| Humana | $14 | 98% |
| Kansas Health | $14 | 98% |
| Aetna | $14 - $386 | 98% |
| Cigna | $14 | 98% |
| Centura Employee Plan | $18 | 126% |
| UnitedHealthcare | $318 | 2228% |
| Wpaa | $338 | 2369% |
| Multiplan | $386 - $434 | 2705% |
| Christian Health Aid | $386 | 2705% |
| Health Partners Of Kansas | $434 | 3041% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Centura St. Catherine-Dodge City, the facility's cash median price is $193.00, which is significantly lower than the state average of $318.00. While Medicare reimburses $14.27 for this service, commercial insurance negotiated rates vary widely; for instance, Aetna plans range from $14 to $386, and UnitedHealthcare plans are fixed at $318. For patients with high-deductible plans, paying the cash price of $193.00 upfront may be more cost-effective than relying on insurance, especially since some negotiated rates exceed the cash amount. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the total cost.
It is important to understand that commercial insurance rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to the true cost of care. If you are billed for the difference between the facility's full chargemaster rate and your insurance allowed amount, this is known as balance billing, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure accuracy, always request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive an unexpected balance bill, you should dispute it in writing with the insurer and request a No Surprises Act audit rather than paying immediately