Hepatitis C antibody test
Facility: Cheyenne County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $66
- Cash Discount Price: $69
- vs. Medicare Baseline: 4.63x 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 463% of the Medicare baseline (a markup of 363%). 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 |
|---|---|---|
| UnitedHealthcare | $10 - $69 | 70% |
| Blue Cross Blue Shield | $45 | 315% |
| First Health - All Plans | $48 | 336% |
| Choice Care - All Plans | $50 | 350% |
| Healthy Blue Mcr Adv | $50 | 350% |
| Aetna | $50 - $66 | 350% |
| Tricare | $50 | 350% |
| Firstguard - All Plans | $55 | 385% |
| Wppa - All Plans | $62 | 434% |
| Preferred Hc - All Plans | $66 | 463% |
| Cpm - All Plans | $66 | 463% |
| Midlands Choice - All Plans | $67 | 470% |
| Ppo Next - All Plans | $68 | 477% |
| Integrated Hp - All Plans | $68 | 477% |
| Unicare - All Plans | $68 | 477% |
| Health Partners - All Plans | $68 | 477% |
| Healthy Blue Mcaid - All Other Plans | $69 | 484% |
| Healthwave Mcaid - All Plans | $69 | 484% |
| Childrens Mercy - All Plans | $69 | 484% |
| Providers Care-All Plans | $104 | 729% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Cheyenne County Hospital, the cash price is $69.00, which matches the facility's gross charge and the highest negotiated rate among the 20 payers listed. While the median negotiated rate across all payers is $66.00, the cash price remains the most consistent figure, with the lowest negotiated amount being $10.00 for UnitedHealthcare. This test is categorized as a Critical Access Hospital service in Kansas, and the facility's cash rate aligns with the cash median of $69.00. Patients with high-deductible plans may find paying the full cash price upfront more economical than relying on insurance, as the negotiated rates for some carriers exceed the cash amount, and prompt-pay discounts could further reduce the final cost if requested before scheduling.
The Medicare benchmark for this procedure is $14.27, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $69.00 represents a significant increase over the Medicare rate, reflecting the administrative costs and profit margins inherent in commercial billing. Although the facility is a voluntary non-profit located in St. Francis, KS (ZIP 67756), the wide variance in negotiated rates—from $10 to $104—highlights the importance of verifying specific plan allowances. Consumers are advised to request an itemized billing audit to ensure no unbundled codes or services not rendered are included, and to explicitly ask for self-pay or prompt-pay discounts prior to check-in to avoid automatic claims submission that could void potential cash savings.