Hepatitis C antibody test
Facility: Kiowa County Memorial Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $140
- Cash Discount Price: $133
- vs. Medicare Baseline: 9.81x 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 981% of the Medicare baseline (a markup of 881%). 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 - $140 | 315% |
| UnitedHealthcare | $126 - $157 | 883% |
| Health Partners Of Ks-All Plans | $138 | 967% |
| Celtic Comml Exchange-All Other Plans | $140 | 981% |
| Medica Prime Mcare Cost-All Plans | $140 | 981% |
| Humana | $140 | 981% |
| Aetna | $140 | 981% |
| Medicaid / KanCare | $157 | 1100% |
| Providrs Care/Wppa-All Plans | $236 | 1654% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT code 86803) at Kiowa County Memorial Hospital in Greensburg, KS, the facility's cash price of $133 is lower than the gross charge of $157 but slightly higher than the state average of $133. While commercial insurance plans like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $45 to $157, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $133 rate avoids the multi-layered costs embedded in insurance billing cycles. It is important to verify your specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than paying out-of-pocket.
To minimize potential costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Since the facility is a Critical Access Hospital owned by the local government, they may offer uniform pricing incentives that bypass standard claims processing fees. Additionally, because Medicare sets a benchmark rate of $14.27 for this service, the commercial negotiated rates observed here reflect a significant markup typical of the healthcare system. If you receive a bill, always request a full itemized statement to ensure no errors exist before paying, and remember that federal protections like the No Surprises Act may prevent balance billing for out-of-network services at this in-network facility.