Hepatitis C antibody test
Facility: Lane County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $62
- Cash Discount Price: $62
- vs. Medicare Baseline: 4.34x 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 434% of the Medicare baseline (a markup of 334%). 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 |
|---|---|---|
| Aetna | $47 - $122 | 329% |
| UnitedHealthcare | $47 - $128 | 329% |
| Healthy Blue Mcaid | $52 - $128 | 364% |
| Medicaid / KanCare | $52 - $141 | 364% |
| Healthy Blue Mcr Adv - All Other Plans | $52 - $128 | 364% |
| Wppa Providers-All Plans | $78 - $192 | 547% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Lane County Hospital in Dighton, KS, the cash price is $62.00, which matches the facility's median negotiated rate and the median amount paid by insurers. This price is significantly higher than the Medicare benchmark of $14.27, reflecting a markup of 4.3 times the federal rate. While commercial payers such as Aetna, UnitedHealthcare, and Medicaid/KanCare negotiate rates ranging from $47 to $192 depending on the specific plan, these negotiated amounts often exceed the cash price. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the $62.00 cash price directly may result in lower total costs compared to using insurance, which could lead to higher allowed amounts or balance billing if the deductible is not met.
To minimize costs, patients should proactively contact the hospital to inquire about self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% if paid upfront. It is also important to request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed. Since this facility is a Critical Access Hospital owned by a Government Hospital District, patients should verify whether their specific insurance plan is in-network and check for any "self-pay" classification options before scheduling the test to avoid unexpected charges.