Hepatitis C antibody test
Facility: Stanton County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $140
- Cash Discount Price: $122
- 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 | $43 - $230 | 301% |
| Healthy Blue Mcr Adv - All Other Plans | $139 - $238 | 974% |
| Healthy Blue Mcaid | $142 - $207 | 995% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Stanton County Hospital in Johnson, KS, the cash price is $122.00, which matches the facility's median negotiated rate of $140.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan, paying the $122.00 cash price upfront may be more cost-effective than relying on insurance, which could result in a higher allowed amount or a large out-of-pocket balance if your deductible is not yet met. Always ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final cost.
The data indicates that the cash price of $122.00 is significantly lower than the median paid amount of $137.00 and the median negotiated rate of $140.00, suggesting that commercial insurance contracts for this service are marked up relative to cash payments. Although specific county or state average comparisons are not provided in this dataset, the facility's cash rate remains the most transparent baseline for comparison. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, which is restricted for emergency care and non-emergency services at in-network facilities under the No Surprises Act. To avoid surprise costs, request a full itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.