Hepatitis C antibody test
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $45
- Cash Discount Price: $16
- vs. Medicare Baseline: 3.15x 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 315% of the Medicare baseline (a markup of 215%). 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 |
|---|---|---|
| Meritain Health [503200039] | $27 - $55 | 189% |
| Wppa [503200056] | $27 - $38 | 189% |
| Alt Wppa [5032000964] | $27 - $38 | 189% |
| Alt Carelon Behavioral Health [503200905] | $32 - $46 | 224% |
| Aetna | $38 - $55 | 266% |
| Allied National [503999937] | $38 - $55 | 266% |
| Php [503200005] | $38 - $55 | 266% |
| Aha-Healthcare Preferred [503200050] | $38 - $55 | 266% |
| National Assn Letter Carriers [503200019] | $38 - $55 | 266% |
| Alt Meritain Health [503999911] | $38 - $55 | 266% |
| Cigna | $38 - $73 | 266% |
| First Health [5032000110] | $38 - $55 | 266% |
| Correct Care Solutions [50311253] | $45 - $64 | 315% |
| Workers Comp [503999901] | $54 - $77 | 378% |
| Usa Managed Care [503999030] | $58 - $82 | 406% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at the University of KS Health System Great Bend Campus, the facility's cash median price of $16.00 is significantly lower than the state average of $33.00, making it a potentially cost-effective option for patients with high-deductible plans or those without insurance. While commercial payers negotiate rates ranging from $27 to $82 depending on the carrier, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status before relying on insurance, as paying the full negotiated rate without meeting the deductible can result in higher out-of-pocket costs than paying cash directly. Additionally, asking the facility about "self-pay" or "prompt-pay" discounts before scheduling can further reduce the final bill, as hospitals often offer fee reductions for upfront payments to bypass costly claims processing.
When evaluating this charge, it is important to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster list. The Medicare amount for this service is $14.27, which serves as a scientifically validated baseline for the true cost of delivery, whereas commercial rates typically average 200% to 300% of this figure. Although the facility's negotiated median of $45.00 is higher than the Medicare rate, the cash price of $16.00 remains well below both the Medicare benchmark and the state average, highlighting a significant opportunity for savings. To ensure accuracy, patients should request an itemized billing audit to confirm that no unbundled codes or services not rendered are included in the final invoice, as over 80%