Hepatitis C antibody test
Facility: Amberwell Atchison Association
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $71
- Cash Discount Price: $158
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $43 - $45 | 301% |
| Triwest - All Plans | $52 | 364% |
| Va Ccn - All Plans | $52 | 364% |
| Superior Select Mcr Adv - All Plans | $52 | 364% |
| Humana | $52 - $71 | 364% |
| UnitedHealthcare | $52 - $283 | 364% |
| Ambetter / Centene | $81 | 568% |
| Cigna | $87 | 610% |
| Aetna | $87 | 610% |
| Oscar - All Plans | $118 | 827% |
| Centrus Health Direct - All Plans | $118 | 827% |
| Multiplan - All Plans | $123 | 862% |
| Wppa Providrs Care - All Plans | $142 | 995% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT code 86803) at Amberwell Atchison Association in Atchison, KS, the cash price is $158.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a 5.0% variance versus Medicare. While commercial insurance plans like UnitedHealthcare and Humana negotiate rates ranging from $52 to $283, these negotiated amounts often exceed the cash price. For patients with high-deductible plans, paying the $158.00 cash price directly may result in lower out-of-pocket costs compared to having insurance pay a negotiated rate that leaves a large deductible balance. Patients should verify their specific plan's deductible status and ask the facility about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not overpaying for insurance processing.
It is important to understand that commercial negotiated rates can sometimes be higher than cash prices due to administrative costs and contract dynamics, even though they protect members from balance billing. The No Surprises Act generally prevents balance billing for out-of-network services at in-network facilities, but patients should still review their itemized bills carefully to ensure no unbundled codes or services not rendered are included. Since over 80% of hospital bills contain errors, requesting a full itemized CPT-coded statement is the most effective way to identify discrepancies and negotiate a lower amount. If a patient receives a summary bill, they should demand a detailed breakdown before agreeing to payment terms, as this reveals the exact charges and helps avoid unexpected costs.