Hepatitis C antibody test
Facility: Lincoln County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $45
- Cash Discount Price: $98
- vs. Medicare Baseline: 3.15x 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 315% of the Medicare baseline (a markup of 215%). 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 | $45 | 315% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Lincoln County Hospital, the cash price of $98.00 is significantly lower than the state average of $109.00, making it a cost-effective option for self-pay patients. While the facility's negotiated rate with Blue Cross Blue Shield is $45.00, this amount is still higher than the cash price, which can be advantageous for individuals with high-deductible plans who may not yet have met their out-of-pocket maximum. Because the cash rate is lower than the insurance negotiated rate, paying directly can sometimes result in immediate savings, provided you confirm with the hospital that they will not submit a claim to your insurer, which could void the discount.
It is important to note that while the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, it does not automatically apply to all non-emergency lab tests or prevent potential balance billing if ancillary services are out-of-network. To ensure you receive the best possible rate, we recommend requesting a formal itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, ask the billing department about "prompt-pay" discounts, which can further reduce the cost if you settle the bill upfront, and always verify your plan's deductible status to avoid unexpected out-of-pocket expenses.