Hepatitis C antibody test
Facility: Greenwood County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $36
- Cash Discount Price: $34
- vs. Medicare Baseline: 2.52x 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 252% of the Medicare baseline (a markup of 152%). 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 |
|---|---|---|
| UnitedHealthcare | $6 - $35 | 42% |
| Triwest - All Plans | $15 | 105% |
| Tricare | $18 | 126% |
| Choicecare Mcr Adv - All Plans | $18 | 126% |
| Integrated Health Plan - All Plans | $32 | 224% |
| Beech Street - All Plans | $36 | 252% |
| First Health - All Other Plans | $36 | 252% |
| First Health Ccn Network | $36 | 252% |
| Preferred Hs (Coventry) - All Plans | $38 | 266% |
| Principal Health Care Inc - All Plans | $40 | 280% |
| Blue Cross Blue Shield | $42 - $45 | 294% |
| Amerigroup Mcaid-All Plans | $42 | 294% |
| Medicaid / KanCare | $42 | 294% |
| Providrs Care/Wppa - All Plans | $63 | 441% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Greenwood County Hospital in Eureka, Kansas, the cash price of $34.00 is lower than the facility's negotiated rates with most major payers, which range from $35.00 to $63.00. While the cash price is slightly below the state average of $35.00, patients with high-deductible plans may find that paying out-of-pocket is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. It is important to note that while the facility is a Critical Access Hospital owned by the local government, commercial insurance contracts can sometimes result in higher costs than direct payment, so verifying your specific plan's allowed amount before scheduling is essential.
To ensure you are not overcharged, always request an itemized bill before paying, as summary bills often hide errors or unbundled charges that could reduce your total cost. Additionally, ask explicitly about "self-pay" or "prompt-pay" discounts, which can lower the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency services and non-emergency care at in-network facilities.