Hepatitis C antibody test
Facility: Great Plains Of Sabetha
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $59
- Cash Discount Price: $62
- vs. Medicare Baseline: 4.13x 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 413% of the Medicare baseline (a markup of 313%). 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 |
|---|---|---|
| Celtic Mcr Adv | $32 | 224% |
| Aetna | $33 - $63 | 231% |
| Celtic Comm Exchange-All Other Plans | $40 | 280% |
| Great West Healthcare-All Plans | $53 | 371% |
| UnitedHealthcare | $58 - $62 | 406% |
| Humana | $59 | 413% |
| Century/Wppa/Providers-All Plans | $59 | 413% |
| Cigna | $59 | 413% |
| Multiplan-Phcs-All Plans | $59 | 413% |
| Federated Mutual Ins-All Plans | $60 | 420% |
| Blue Cross Blue Shield | $62 | 434% |
| Medicaid / KanCare | $62 | 434% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Great Plains Of Sabetha in Sabetha, Kansas, the cash price is $62.00, which matches the facility's gross charge and the state average. While commercial insurance negotiated rates typically range from $32 to $63 depending on the plan, the cash price remains the lowest option available in this dataset. Patients with high-deductible plans may find paying the full $62.00 upfront more cost-effective than relying on insurance, as many commercial payers have negotiated rates that exceed the cash price due to administrative overhead and contract structures. It is important to verify your specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest price can lead to higher out-of-pocket costs if your deductible has not yet been met.
The facility's cash rate of $62.00 is consistent with the Medicare amount of $14.27 when adjusted for the facility's Critical Access Hospital status and location, reflecting a standard markup typical for this service type. Although the facility is a voluntary non-profit, the data shows no specific self-pay or prompt-pay discounts listed in the current price transparency report, so patients should directly contact the billing department to inquire about potential fee reductions for upfront payment. To ensure accuracy, consumers should request a full itemized bill rather than accepting a summary invoice, as these detailed statements allow for the identification of any unbundled codes or services not rendered. Finally, if you encounter a balance bill from an out-of-network provider at this in-network facility, you may be entitled to protections under the No Surprises Act, which prohibits balance billing for certain non-emergency