Hepatitis C antibody test
Facility: Overland Park Reg Med Ctr
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $184
- Cash Discount Price: $1,038
- vs. Medicare Baseline: 12.89x 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 1289% of the Medicare baseline (a markup of 1189%). 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 |
|---|---|---|
| Cigna | $7 - $15 | 49% |
| Aetna | $13 - $554 | 91% |
| Home State Health Plan | $13 | 91% |
| United | $13 - $489 | 91% |
| Amerigroup | $14 | 98% |
| Coventry | $14 - $437 | 98% |
| Blue Cross Blue Shield | $14 - $468 | 98% |
| Humana | $14 - $35 | 98% |
| Devoted Health | $14 | 98% |
| Wellcare | $15 | 105% |
| Pyramid Life | $15 | 105% |
| Celtic | $15 | 105% |
| Medicaid / KanCare | $15 | 105% |
| Unicare | $15 | 105% |
| Healthyblue | $15 | 105% |
| Triwest Health Alliance | $15 | 105% |
| Oscar | $22 | 154% |
| Multiplan | $25 - $805 | 175% |
| Corvel Corporation | $30 - $707 | 210% |
| Oha Network | $31 - $544 | 217% |
| Ambetter / Centene | $184 - $202 | 1289% |
| Nhc Advantage | $188 - $207 | 1317% |
| Wppa Providrs Care Network | $198 - $217 | 1388% |
| Universal Healthcare | $346 - $381 | 2425% |
| Coventry Kc Mo | $405 - $446 | 2838% |
| College Park Family Care Center | $425 - $468 | 2978% |
| Cco, Inc. | $741 - $815 | 5193% |
| Focus Healthcare Mgmt, Inc | $741 - $815 | 5193% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT code 86803) at Overland Park Reg Med Ctr, the cash price is $1,038, which matches the facility's cash median. This rate is 12.9% higher than the Medicare benchmark of $14.27, reflecting the typical markup found in commercial healthcare pricing. While the facility offers a negotiated rate of $184 for in-network patients, this amount is significantly lower than the cash price, suggesting that for those with high-deductible plans or those who have met their deductible, using insurance may result in a lower out-of-pocket cost compared to paying cash. However, patients should verify their specific plan's allowed amount before scheduling, as negotiated rates can vary widely between payers, with some plans paying as low as $7 and others up to $815 for this service.
To ensure you are receiving the best possible price, it is important to understand that commercial insurance rates often include administrative overhead that can inflate the baseline price by 20% to 40% above the true cost of care. If you choose to pay cash, you may be eligible for a prompt-pay discount, which typically ranges from 20% to 50% off the billed amount when paid in full upfront. This discount bypasses the costly claims processing cycle that insurance billing requires, allowing the facility to offer a reduced rate for immediate payment. Before check-in, you should explicitly request a self-pay classification and ask about prompt-pay incentives to avoid being automatically enrolled in the standard insurance billing process, which could void any potential cash savings.