Hepatitis C antibody test
Facility: Norton County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $63
- Cash Discount Price: $112
- vs. Medicare Baseline: 4.41x 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 441% of the Medicare baseline (a markup of 341%). 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 | $63 | 441% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Norton County Hospital, the cash price of $112.00 is significantly lower than the negotiated rate of $63.00 paid by Blue Cross Blue Shield, which is the only payer listed for this service. While the facility is a Critical Access Hospital in Norton, KS, the cash price does not align with typical state or county averages provided in this report, suggesting that paying out-of-pocket may offer a better financial outcome for patients with high-deductible plans or those without insurance. Because the negotiated rate exceeds the cash price, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost.
It is important to understand that commercial insurance rates often include administrative overhead and contract markups that can make them higher than direct cash payments, even though they are contractually capped. If you choose to use insurance, be aware that the facility may still attempt to balance bill you for the difference between the negotiated rate and the amount your plan covers, though the No Surprises Act protects you from such billing for out-of-network services at in-network facilities. To ensure you receive the most accurate and transparent pricing, always request a full itemized bill before paying, as summary invoices can obscure individual charges. If you receive a bill that appears to include services not rendered or unbundled codes, you have the right to dispute it in writing to avoid unnecessary debt.