Hepatitis C antibody test
Facility: Greeley County Health Services
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $62
- vs. Medicare Baseline: 0.98x 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.
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 |
|---|---|---|
| Medicaid / KanCare | $14 | 98% |
| Aetna | $14 | 98% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Greeley County Health Services, the cash price of $62.00 is significantly lower than the negotiated rates paid by insurance carriers, which range between $14.00 and $14.00 for both Medicaid/KanCare and Aetna. While the facility's cash rate appears higher than the specific negotiated amounts listed here, it is important to note that cash prices can sometimes be more cost-effective for patients with high-deductible plans if their insurance allowed amount exceeds the cash price. Since this facility is a Critical Access Hospital in Tribune, KS, patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary widely even within the same county.
To ensure you are not overpaying, we recommend requesting a "prompt-pay" discount if you choose to pay out-of-pocket, as hospitals often offer 20% to 50% reductions for upfront payments that bypass costly insurance billing cycles. Additionally, because over 80% of hospital bills contain errors, we advise requesting a full itemized statement before paying to identify any unbundled codes or services not rendered. While the data provided does not include a direct comparison to state or county averages for this specific code, using the Medicare benchmark of $14.27 as a baseline helps clarify that commercial negotiated rates often include administrative markups that do not reflect the true cost of care.