Hepatitis C antibody test
Facility: Rawlins County Health Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $117
- Cash Discount Price: $115
- vs. Medicare Baseline: 8.20x 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 820% of the Medicare baseline (a markup of 720%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $45 | 315% |
| UnitedHealthcare | $117 | 820% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Rawlins County Health Center in Atwood, Kansas, the cash price of $115.00 is notably lower than the facility's negotiated rates of $117.00 and the commercial payer ranges of $45.00 to $117.00. While the facility's cash rate is higher than the Medicare benchmark of $14.27, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated amount could be unnecessary if you have not yet met your out-of-pocket threshold.
To ensure you are not overcharged, always request a prompt-pay discount or self-pay rate before check-in, as hospitals often offer significant reductions for upfront payment that bypass insurance billing cycles. If you receive a bill after using insurance, do not accept a summary invoice; instead, demand a full itemized audit to identify any unbundled codes, services not rendered, or balance billing errors. Given that over 80% of hospital bills contain errors, a line-by-line review is the most effective way to dispute charges and avoid unexpected debt, particularly if you encounter out-of-network ancillary services or administrative fees that inflate the final cost.