Hepatitis C antibody test
Facility: Kearny County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $152
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 10.65x 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 1065% of the Medicare baseline (a markup of 965%). 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 |
|---|---|---|
| Wps Gha - Mac J5 Part A | $152 | 1065% |
| Blue Cross Blue Shield | $152 | 1065% |
| Community Care Health Plan Of | $152 | 1065% |
| Luminare Health | $152 | 1065% |
| UnitedHealthcare | $152 | 1065% |
| Aetna | $152 | 1065% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Kearny County Hospital in Lakin, KS, the negotiated rate is $152.00, which matches the facility's cash median and the lowest possible amount charged by any payer. This price is significantly higher than the Medicare benchmark of $14.27, reflecting a markup of 1070% over the federal baseline. While commercial insurance contracts often result in rates between 200% and 300% of Medicare, this specific service represents a substantial deviation from typical commercial pricing norms. Given that the facility is a Critical Access Hospital with government-local ownership, patients should verify if their specific insurance plan has a lower allowed amount, as some carriers may negotiate below the published median.
Patients should be aware that cash-pay options can sometimes offer savings if a patient's insurance deductible has not yet been met, particularly since the cash price here aligns with the lowest negotiated rate available. It is recommended to request an itemized billing audit before finalizing payment to ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors. Additionally, inquiring about prompt-pay discounts or self-pay rates prior to scheduling can help avoid unexpected costs, as hospitals often offer immediate fee reductions for upfront payments that bypass the administrative overhead of insurance claims processing.