Hepatitis C antibody test
Facility: Kansas Heart Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $36
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Aetna | $6 - $11 | 42% |
| Tricare | $13 | 91% |
| UnitedHealthcare | $14 | 98% |
| Humana | $14 | 98% |
| Medicaid / KanCare | $14 | 98% |
| Celtic Mcr Adv | $14 | 98% |
| Wppa - All Plans | $16 - $30 | 112% |
| Blue Cross Blue Shield | $30 | 210% |
| Multiplan - All Plans | $36 - $67 | 252% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Kansas Heart Hospital in Wichita, KS, the facility's cash median price of $36.00 is significantly higher than the Medicare benchmark of $14.27, reflecting the standard commercial markup often seen in acute care settings. While the facility's negotiated rate of $14.00 aligns closely with the state average, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price. Given that the facility is a proprietary acute care hospital, it is advisable to contact them directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront, bypassing the administrative overhead associated with insurance claims.
The data indicates that while the facility's cash rate is elevated compared to the Medicare baseline, the negotiated amount of $14.00 remains competitive relative to the broader market. However, patients must verify their specific plan's allowed amount before scheduling, as in-network rates vary widely and some commercial payers may negotiate higher fees than the facility's published average. To ensure you are receiving the best possible price, request a full itemized bill before paying, as summary invoices can obscure individual charges or unbundled services. If you encounter a balance bill for out-of-network ancillary services, remember that the No Surprises Act protects you from paying the difference for emergency care or non-emergency services at in-network facilities, allowing you to dispute the charge with your insurer rather than paying immediately.