Hepatitis C antibody test
Facility: Nemaha Valley Community Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $61
- Cash Discount Price: $106
- vs. Medicare Baseline: 4.27x 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 427% of the Medicare baseline (a markup of 327%). 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 |
|---|---|---|
| Va Ccn - All Plans | $17 | 119% |
| Aetna | $52 - $100 | 364% |
| Humana | $52 | 364% |
| Celtic Comm Exch - All Plans | $57 | 399% |
| Partners Direct Health - All Plans | $61 | 427% |
| Multiplan - All Plans | $106 | 743% |
| Health Partners - All Plans | $112 | 785% |
| Midlands Choice - All Plans | $112 | 785% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $106.00, which is 4.3% higher than the Medicare benchmark of $14.27. While the facility's negotiated rates for in-network payers range from $52 to $112, the cash price often represents a more affordable option for patients with high-deductible plans or those without insurance, as it avoids the administrative overhead and markup inherent in insurance billing cycles. Patients should verify if their specific plan falls within the $52 to $112 negotiated range, but be aware that commercial rates can sometimes exceed cash prices due to the costs of claims processing and contract management.
To secure the lowest possible cost, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is critical to avoid automatic claims submission, which may void any cash agreement and trigger balance billing if the provider is out-of-network for specific services. If a surprise bill arises, consumers should dispute it in writing rather than paying immediately, and always demand a full itemized audit to identify errors or unbundled charges before finalizing payment.