Hepatitis C antibody test
Facility: Kansas Surgery & Recovery Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $15
- Cash Discount Price: $45
- 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 |
|---|---|---|
| UnitedHealthcare | $6 - $14 | 42% |
| Aetna | $14 - $42 | 98% |
| Blue Cross Blue Shield | $14 - $45 | 98% |
| Triwest | $15 | 105% |
| Cigna | $24 | 168% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test at Kansas Surgery & Recovery Center in Wichita, KS, the cash price is $45.00, which matches the facility's listed gross charge. This cash rate is significantly higher than the state average, as indicated by a Medicare benchmark ratio of 1.1, suggesting the facility's pricing is 10% above the federal baseline for this service. While commercial insurance plans like UnitedHealthcare, Aetna, and Blue Cross Blue Shield have negotiated rates ranging from $14 to $45 depending on the specific plan, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the $45.00 cash rate directly, as this avoids potential balance billing if their insurance allows a lower negotiated amount that still requires an out-of-pocket payment.
To ensure you receive the best possible rate, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if settled upfront. Although the data shows a median negotiated rate of $15.00 across payers, this figure represents an average and does not reflect every individual plan's specific coverage. Before scheduling, verify your specific deductible status and allowed amount, as paying the full cash price without meeting your deductible could result in higher out-of-pocket costs than anticipated. If you receive a bill that appears to include charges for services not rendered or unbundled components, request a formal itemized audit to identify and correct any errors before payment.