Hepatitis C antibody test
Facility: Wichita County Health Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $87
- Cash Discount Price: $76
- vs. Medicare Baseline: 6.10x 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 610% of the Medicare baseline (a markup of 510%). 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 |
|---|---|---|
| Medicaid / KanCare | $78 | 547% |
| UnitedHealthcare | $95 | 666% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Wichita County Health Center in Leoti, KS, the facility's cash price of $76.00 is lower than the state average of $78.00, making it a cost-effective option for self-pay patients. While the facility's negotiated rate with UnitedHealthcare is $95.00, which exceeds the cash price, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allows less than the negotiated amount. It is important to note that Medicaid/KanCare has a fixed allowed amount of $78.00, which aligns with the state median paid. To ensure the lowest possible cost, patients should verify their specific plan's allowed amount before scheduling and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
When reviewing your bill, be aware that commercial insurance rates often include administrative overhead that can inflate the price above the true cost of care. The Medicare benchmark for this service is $14.27, which serves as a baseline for fair pricing; commercial rates are typically marked up significantly above this figure. If you receive a bill that includes charges for services not rendered or unbundled components, you should request a full itemized audit rather than accepting a summary invoice. Furthermore, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, so you should dispute any unexpected charges immediately rather than paying them out of fear of credit damage. Always confirm that your provider is in-network and check your deductible status to avoid unexpected out-of-pocket expenses.