Hepatitis C antibody test
Facility: Mercy Hospital Columbus
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $74
- Cash Discount Price: $66
- vs. Medicare Baseline: 5.19x 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 519% of the Medicare baseline (a markup of 419%). 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 | $13 - $74 | 91% |
| Humana | $13 - $97 | 91% |
| UnitedHealthcare | $13 - $85 | 91% |
| Blue Cross Blue Shield | $13 - $74 | 91% |
| Ambetter / Centene | $14 - $74 | 98% |
| Medicare (plans) | $15 - $77 | 105% |
| Health Systems Inc Contracted [320174] | $44 | 308% |
| Insurance System Inc Contracted [320465] | $44 | 308% |
| Administrative Payor Contracted [320005] | $46 | 322% |
| Tricare | $74 | 519% |
| Pace Of The Ozarks Contracted [320518] | $74 | 519% |
| Provider Partners Health Plans Contracted [320450] | $74 | 519% |
| Cherokee Nation Health Serv Contracted [320066] | $74 | 519% |
| Centurion Of Missouri [20459] | $74 | 519% |
| Aetna | $74 - $92 | 519% |
| Qual Choice Contracted [320325] | $74 | 519% |
| Home State Health Plan Contracted [320187] | $74 | 519% |
| Halo Hcr Inc Hospice Contracted [320432] | $74 | 519% |
| Indian Health Service Contracted [320198] | $74 | 519% |
| Globalhealth Contracted [320145] | $74 | 519% |
| Medical Associates Health Contracted [320444] | $74 | 519% |
| Novasys Contracted [320285] | $74 | 519% |
| Mercy Hospice Okc [20252] | $74 | 519% |
| Cigna | $74 | 519% |
| Mercy Mgd Behavioral Health Contracted [320259] | $74 | 519% |
| Halo Hcr Inc Hospice [20432] | $74 | 519% |
| Cross Timbers Hospice [20098] | $74 | 519% |
| Elara Caring Aspire Hospice [20433] | $74 | 519% |
| Kindful Hospice [20434] | $74 | 519% |
| Dept Of Veteran Affairs Contracted [320106] | $74 | 519% |
| Kindful Hospice Contracted [320434] | $74 | 519% |
| Healthscope Contracted [320182] | $79 | 554% |
| Workers Comp [20426] | $82 - $87 | 575% |
| United Medical Resources Contracted [320454] | $85 - $97 | 596% |
| Medica Contracted [320239] | $91 | 638% |
| Federal Medical Center Contracted [320127] | $92 | 645% |
| Usa Managed Care Org Contracted [320429] | $92 | 645% |
| Preferred Health Plan Contracted [320522] | $92 | 645% |
| Healthlink Contracted [320179] | $92 - $97 | 645% |
| American Healthcare Alliance Contracted [320020] | $92 | 645% |
| Mercy Benefit Admin Contracted [320251] | $92 - $97 | 645% |
| First Health Contracted [320128] | $92 | 645% |
| Auxiant Contracted [320462] | $97 | 680% |
| Benefit Management Contracted [320052] | $97 | 680% |
| 90 Degree Benefits Contracted [320436] | $97 | 680% |
| Yuzu Health Contracted [320521] | $97 | 680% |
| Aither Health Contracted [320449] | $97 | 680% |
| Edison Health Solutions Contracted [320502] | $97 | 680% |
| Show-Me Health Administrators Contracted [320483] | $97 | 680% |
| Private Health Care Systems Contracted [320320] | $97 | 680% |
| Imagine 360 Contracted [320494] | $97 | 680% |
| Ppo Plus Contracted [320310] | $97 | 680% |
| Point C Contracted [320238] | $97 | 680% |
| Ebms Contracted [320493] | $97 | 680% |
| Reflect Health Contracted [320492] | $97 | 680% |
Consumer Guidance & Cost Commentary
If you are paying cash for this Hepatitis C antibody test, the most important thing to know is that the facility's self-pay cash rate of $66 is significantly lower than the facility's gross chargemaster price of $102, offering a clear discount for upfront payment. While commercial insurance plans typically negotiate rates that range from $13 to $97 depending on the carrier, the cash price of $66 may actually be the most cost-effective option for patients with high-deductible plans or those without insurance, as it bypasses the administrative overhead and negotiated ceilings that often result in higher out-of-pocket costs. Patients should explicitly ask the hospital during registration for a "self-pay" or "prompt-pay" classification to ensure they receive this lower rate and avoid having the claim submitted to an insurer, which could trigger a higher negotiated payment rather than the cash discount.
The broader pricing context shows that this facility is a Voluntary non-profit - Church owned Critical Access Hospital in Columbus, KS, where the cash rate of $66 is notably lower than the state of Kansas average of $74. Although the facility's gross charges of $102 are substantially higher than both the cash and state averages, the median negotiated rate of $74 reflects the typical range seen across various payers, with some plans paying as low as $13 and others up to $97. It is crucial to note that the Medicare amount for this service is $14.27, which serves as a federal benchmark; commercial rates are often higher than this baseline due to administrative structures, but the cash price of $66 remains a transparent, fixed amount that does not fluctuate based on insurance status or network tier