Hepatitis C antibody test
Facility: Logan County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $110
- Cash Discount Price: $32
- vs. Medicare Baseline: 7.71x 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 771% of the Medicare baseline (a markup of 671%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $45 | 315% |
| Humana | $68 | 477% |
| Health Partners - All Plans | $152 | 1065% |
| Medicaid / KanCare | $160 | 1121% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Logan County Hospital in Oakley, KS, the facility's cash price of $32.00 is significantly lower than the negotiated rates charged to major insurers like Blue Cross Blue Shield ($45), Humana ($68), and Health Partners ($152). While the median amount paid by these payers is $110.00, the cash price represents a substantial discount that could save patients with high-deductible plans who have not yet met their coverage thresholds. Because the cash rate is lower than the insurer's allowed amount, patients with self-pay or prompt-pay options may find it more financially advantageous to pay directly, provided they confirm the discount with the hospital before scheduling to avoid automatic insurance billing.
The facility's pricing also compares favorably against federal benchmarks, with the cash rate being roughly 2.2 times the Medicare amount of $14.27, which serves as a reliable baseline for fair pricing. Although the data does not include specific county or state average comparisons for this service, the transparent gap between the gross charge of $160.00 and the cash price highlights the importance of verifying "self-pay" or "prompt-pay" discounts prior to receiving care. Patients are encouraged to request an itemized bill to ensure no unexpected ancillary services or balance billing occurs, as federal protections like the No Surprises Act may prevent surprise charges for out-of-network components even at in-network facilities.