Hepatitis C antibody test
Facility: Osborne County Memorial Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $63
- Cash Discount Price: $62
- 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 |
|---|---|---|
| UnitedHealthcare | $49 - $61 | 343% |
| Health Partners Of Kansas | $56 - $69 | 392% |
| Wppa | $62 - $76 | 434% |
| Blue Cross Blue Shield | $64 - $78 | 448% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Osborne County Memorial Hospital in Osborne, KS, the facility's cash median price of $62.00 is notably lower than the state average of $63.00 and the negotiated rate of $63.00. While the hospital is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that commercial payers like UnitedHealthcare, Health Partners Of Kansas, Wppa, and Blue Cross Blue Shield have negotiated rates ranging from $49 to $78, which often exceed the cash price due to administrative costs and contract structures.
To ensure you are not overcharged, always request a prompt-pay discount before scheduling, as paying in full upfront can significantly reduce the final bill. If you receive a summary bill, demand a full itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. Additionally, compare your facility's rates to the Medicare benchmark of $14.27; while commercial rates are typically higher, the cash price here remains competitive. If you encounter unexpected balance billing, remember that the No Surprises Act protects you from out-of-network charges at in-network facilities, and you should dispute any surprise bills in writing rather than accepting them immediately.