Hepatitis C antibody test
Facility: Scott County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $71
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.98x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 498% of the Medicare baseline (a markup of 398%). 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 | $14 - $689 | 98% |
| Humana | $32 - $304 | 224% |
| Wppa | $45 - $1,200 | 315% |
| Blue Cross Blue Shield | $45 | 315% |
| Aetna | $68 - $652 | 477% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Scott County Hospital, the facility's negotiated rates range from $32 to $689 across five payers, with a median negotiated rate of $71.00. This is significantly higher than the Medicare benchmark of $14.27, which serves as the objective baseline for fair pricing. While commercial rates often include administrative overhead and volume discounts, patients should note that cash payments are not always the most expensive option; in some cases, paying cash directly can be cheaper than the insurance negotiated rate, especially for those with high-deductible plans. However, since the cash median is not available in this dataset, it is crucial to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can bypass costly insurance billing cycles.
Patients should be aware that the wide variation in allowed amounts—from $14 at UnitedHealthcare to $1,200 at Wppa—reflects different contract terms rather than a single standard price. Because commercial rates are often inflated by administrative costs and lack the strict caps of Medicare, comparing the facility's rates to the Medicare benchmark reveals the true cost structure. If you receive a bill that exceeds the allowed amount, it may be a balance bill, which is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. To ensure accuracy, always request a full itemized bill before paying, as summary invoices can obscure errors or unbundled charges, and dispute any discrepancies in writing to protect yourself from unexpected debt.