Hepatitis C antibody test
Facility: Satanta District Hospital, Clinics, & Ltcu
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $45
- Cash Discount Price: $57
- vs. Medicare Baseline: 3.15x 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 315% of the Medicare baseline (a markup of 215%). 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 |
|---|---|---|
| Direct Benefit-All Plans | $15 | 105% |
| UnitedHealthcare | $18 - $63 | 126% |
| Berkley Net-All Plans | $25 | 175% |
| Trustmark Health Benefits-All Plans | $28 | 196% |
| Aetna | $28 - $43 | 196% |
| Meritain Health-All Plans | $28 | 196% |
| Ambetter / Centene | $30 | 210% |
| Axa Equitable - All Plans | $35 | 245% |
| Pinnacol-All Plans | $35 | 245% |
| Medi-Share-All Plans | $36 | 252% |
| Presbyterian-All Plans | $38 | 266% |
| Kasb Work Comp - All Plans | $40 | 280% |
| The Kempton Group Admin-All Plans | $43 | 301% |
| Gpha(Wppa)-All Other Plans | $44 | 308% |
| Auxiant - All Plans | $44 | 308% |
| Wppa- All Plans | $45 | 315% |
| Sisco-All Plans | $45 | 315% |
| Emc-All Plans | $45 | 315% |
| Providers Care Network- All Plans | $45 | 315% |
| Gpha Employee Benefit Plan | $46 | 322% |
| Employee Benefit-All Plans | $47 | 329% |
| Regional Care(Wppa)-All Plans | $47 | 329% |
| First Health -All Plans | $48 | 336% |
| Triangle-All Plans | $48 | 336% |
| One Call Physician-All Plans | $49 | 343% |
| Christian Hospital Aid - All Plans | $50 | 350% |
| Tricare | $50 | 350% |
| Blue Cross Blue Shield | $50 | 350% |
| Humana | $54 | 378% |
| Cigna | $55 | 385% |
| Luminare Health- All Plans | $55 | 385% |
| Coresource-All Plans | $57 | 399% |
| Deseret Mutual(Uhis)-All Plans | $57 | 399% |
| Vaccn-All Plans | $58 | 406% |
| Wps Vapc-All Plans | $60 | 420% |
| Hma Llc-All Plans | $60 | 420% |
| Reserve National-All Plans | $60 | 420% |
| Medicaid / KanCare | $63 | 441% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT code 86803), the facility's cash price of $57.00 is slightly higher than the state average of $45.00, though it remains below the gross chargemaster rate of $63.00. While commercial insurance plans negotiate rates ranging from $15 to $63, many of these negotiated amounts exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the facility is a Critical Access Hospital in Satanta, KS, and government-owned, patients should verify their specific plan's allowed amount before scheduling, as some in-network rates can be significantly higher than the cash rate. Additionally, patients should explicitly ask about "self-pay" or "prompt-pay" discounts at registration, as paying the bill in full upfront can often result in a fee reduction that bypasses the administrative costs associated with insurance billing.
This service is subject to federal protections under the No Surprises Act, which prohibits balance billing for out-of-network providers at in-network facilities, though patients should still review their itemized bills to ensure no unexpected ancillary charges were added. If a bill arrives that appears to include charges for services not rendered or unbundled components, patients should request a formal itemized audit rather than accepting a summary invoice. Furthermore, while the Medicare benchmark for this code is $14.27, commercial rates are often higher due to administrative overhead; however, the cash price of $57.00 is still lower than the highest negotiated rates found among the 38 payers listed, including UnitedHealthcare and Aetna. Consumers