Hepatitis C antibody test
Facility: Menorah Medical Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $30
- Cash Discount Price: $895
- vs. Medicare Baseline: 2.10x 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 210% of the Medicare baseline (a markup of 110%). 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 - $716 | 49% |
| Home State Health Plan | $13 | 91% |
| United | $13 - $403 | 91% |
| Aetna | $13 - $456 | 91% |
| Devoted Health | $14 | 98% |
| Blue Cross Blue Shield | $14 - $403 | 98% |
| Humana | $14 - $35 | 98% |
| Coventry | $14 - $360 | 98% |
| Amerigroup | $14 | 98% |
| Celtic | $15 | 105% |
| Wellcare | $15 | 105% |
| Unicare | $15 | 105% |
| Triwest Health Alliance | $15 | 105% |
| Pyramid Life | $15 | 105% |
| Medicaid / KanCare | $15 | 105% |
| Healthyblue | $15 | 105% |
| Oscar | $22 | 154% |
| Multiplan | $25 - $662 | 175% |
| Corvel Corporation | $30 - $581 | 210% |
| Oha Network | $31 - $447 | 217% |
| Ambetter / Centene | $166 | 1163% |
| Nhc Advantage | $170 | 1191% |
| Wppa Providrs Care Network | $179 | 1254% |
| Universal Healthcare | $313 | 2193% |
| Coventry Kc Mo | $367 | 2572% |
| College Park Family Care Center | $385 | 2698% |
| Focus Healthcare Mgmt, Inc | $671 | 4702% |
| Cco, Inc. | $671 | 4702% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Menorah Medical Center in Overland Park, KS, the cash price is $895.00, which matches the facility's cash median. This rate is significantly higher than the state average, reflecting the facility's proprietary ownership and lack of broad commercial contracts for this specific service. While commercial payers like Cigna and United have negotiated rates ranging from $7 to $716, these amounts are often inflated by administrative costs and the inclusion of deductibles or co-pays that patients may not have yet met. For patients with high-deductible plans, paying the cash price of $895.00 upfront could result in lower out-of-pocket costs compared to using insurance, provided the insurer's allowed amount exceeds the cash rate. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these can reduce the final bill by 20% to 50% when paid in full before or shortly after the service.
When reviewing your bill, it is important to distinguish between the facility's gross charges and the actual amount billed to you. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still arise from ancillary services or coding errors. If you receive a summary bill, you should request a full itemized statement to verify that no services were unbundled or charged for items that were never rendered. Furthermore, the facility's rate of $895.00 is approximately 2.1 times the Medicare amount of $14.27, which serves as