Hepatitis C antibody test
Facility: Kingman Healthcare Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $16
- 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 |
|---|---|---|
| Wellcare | $5 - $20 | 35% |
| UnitedHealthcare | $5 - $45 | 35% |
| Medicaid / KanCare | $5 - $22 | 35% |
| Humana | $5 - $20 | 35% |
| Ambetter / Centene | $5 - $22 | 35% |
| Celtic Insurance Company | $5 - $22 | 35% |
| Cigna | $11 - $45 | 77% |
| Aetna | $11 - $45 | 77% |
| Health Partners | $11 - $45 | 77% |
| Healthy Blue | $14 | 98% |
| Triwest | $14 | 98% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT code 86803) at Kingman Healthcare Center in Kingman, KS, the cash median price is $16.00, which is 12% higher than the Medicare benchmark of $14.27. While the facility is a Voluntary non-profit Critical Access Hospital, the negotiated rates for commercial payers range from $5.00 to $45.00 depending on the insurance plan. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; therefore, patients with high-deductible plans may find paying the cash price of $16.00 more cost-effective than relying on insurance, especially if their plan's negotiated rate exceeds this amount.
Before scheduling, patients should verify their specific plan's allowed amount and check for "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront. Although the data does not provide a specific county or state average for this procedure, understanding that Medicare serves as the objective baseline for fair pricing helps avoid confusion with inflated chargemaster lists. If you receive a bill, always request a full itemized statement to review CPT codes and ensure no services were double-billed or unbundled, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.