Hepatitis C antibody test
Facility: Grisell Memorial Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $59
- Cash Discount Price: $97
- vs. Medicare Baseline: 4.13x 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 413% of the Medicare baseline (a markup of 313%). 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 |
|---|---|---|
| UnitedHealthcare | $15 - $76 | 105% |
| Blue Cross Blue Shield | $42 | 294% |
| Humana | $102 | 715% |
| Medicaid / KanCare | $102 | 715% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Grisell Memorial Hospital in Ransom, KS, the facility's cash median price of $97.00 is notably higher than the state average of $59.00 and the county average of $42.00. While this cash rate exceeds the state median, it remains below the facility's gross chargemaster price of $102.00. For patients with high-deductible plans, paying the cash price directly may be more cost-effective than using insurance, as the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $42.00 to $102.00, which can exceed the cash price depending on the specific plan. Patients should verify their deductible status before scheduling, as paying out-of-pocket might avoid the administrative fees and potential balance billing associated with insurance claims.
To ensure you are not overcharged, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a surprise bill for the difference between the provider's full rate and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the hospital about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle that often inflates the final cost. Always dispute any unexpected charges in writing to avoid credit damage and ensure the