Hepatitis C antibody test
Facility: Morris County Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $64
- Cash Discount Price: $98
- vs. Medicare Baseline: 4.48x 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 448% of the Medicare baseline (a markup of 348%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $14 | 98% |
| Va Ccn-All Plans | $23 | 161% |
| Aetna | $25 | 175% |
| Blue Cross Blue Shield | $43 - $64 | 301% |
| Choice Care Mcr Adv-All Plans | $64 | 448% |
| Coventry Mcr | $64 | 448% |
| UnitedHealthcare | $64 - $163 | 448% |
| Cigna | $118 | 827% |
| Multiplan-All Plans | $147 | 1030% |
| Coventry Comm-All Other Plans | $147 | 1030% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Morris County Hospital in Council Grove, KS, the facility's cash median price is $98.00, which is notably lower than the state average of $147.00. While the hospital's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $64.00 to $163.00, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing prompt-pay discounts. It is important to note that the facility is a Critical Access Hospital with government-local ownership, and while the facility rating is 3, the cash rate remains the most transparent benchmark for comparison.
Patients should be aware that commercial insurance contracts can sometimes result in higher costs than direct payment due to administrative overheads and contract dynamics. For instance, the median negotiated rate of $64.00 is still higher than the cash price of $98.00, suggesting that self-pay or prompt-pay arrangements could be more economical. Furthermore, if this service were part of a larger visit involving out-of-network ancillary services, balance billing could occur, though the No Surprises Act protects patients from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure the lowest possible cost, consumers are encouraged to verify their deductible status and request a formal itemized bill to confirm that no unbundled codes or services not rendered have inflated the final charge.