Hepatitis C antibody test
Facility: Mitchell County Hospital Health Systems
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $61
- Cash Discount Price: $58
- vs. Medicare Baseline: 4.27x 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 427% of the Medicare baseline (a markup of 327%). 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 - $64 | 98% |
| Blue Cross Blue Shield | $45 | 315% |
| Triwest Well Mark All Plans | $54 | 378% |
| First Health-All Plans | $58 | 406% |
| Pref Hlth Care Sytms Comm - All Plans | $58 | 406% |
| Aetna | $58 | 406% |
| Multiplan Ppo - All Plans | $61 | 427% |
| Auxiant-All Plans | $61 | 427% |
| Phc Leased Ntwrk Access - All Plans | $61 | 427% |
| Health Partners Ks-All Plans | $63 | 441% |
| Cigna | $63 | 441% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash median price of $58.00 is notably lower than the state average of $61.00 and the negotiated rate of $61.00. While the Medicare benchmark for this service is $14.27, commercial payers have negotiated rates ranging from $14 to $64, with UnitedHealthcare offering the lowest tier at $14 across three plans. Because the cash price is already below the typical negotiated amount, patients with high-deductible plans may find paying out-of-pocket the most cost-effective option, provided they confirm the facility's "self-pay" or "prompt-pay" discounts before scheduling.
It is important to compare these rates against the Medicare baseline to understand the true cost structure, as commercial rates often reflect administrative overhead and contract dynamics rather than the federal government's cost-based benchmark. Although the facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan's allowed amount, as in-network rates can vary significantly between carriers. To ensure you are not overcharged, always request a detailed, itemized bill that breaks down every CPT code and charge, as summary bills may obscure individual line items. If you receive a balance bill for services rendered at an in-network facility, you may be entitled to protections under the No Surprises Act, which prevents providers from charging you the difference between their full rate and your insurance's allowed amount.