Hepatitis C antibody test
Facility: Jewell County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $91
- Cash Discount Price: $72
- vs. Medicare Baseline: 6.38x 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 638% of the Medicare baseline (a markup of 538%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $82 | 575% |
| Aetna | $87 | 610% |
| Meritain - All Plans | $87 | 610% |
| UnitedHealthcare | $91 | 638% |
| First Health - All Plans | $91 | 638% |
| Midlands Choice - All Plans | $91 | 638% |
| Cigna | $91 | 638% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test at Jewell County Hospital in Mankato, KS, the cash price is $72.00, which is lower than the facility's negotiated rate of $91.00 and the median paid amount of $91.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying cash directly more cost-effective than using insurance, as the negotiated rate exceeds the cash price. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill.
When reviewing your statement, ensure you request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. For this specific CPT code, the Medicare benchmark amount is $14.27, which serves as the objective baseline for evaluating pricing markups. Although the commercial negotiated rate of $91.00 is significantly higher than the Medicare rate, this reflects standard administrative costs and contract dynamics; however, it is important to verify that no balance billing is occurring, as federal protections generally prevent surprise charges for out-of-network services at in-network facilities.