Hepatitis C antibody test
Facility: Bob Wilson Memorial Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $105
- Cash Discount Price: $51
- vs. Medicare Baseline: 7.36x 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 736% of the Medicare baseline (a markup of 636%). 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 |
|---|---|---|
| Centura Employee Plan | $18 | 126% |
| Kansas Health | $41 | 287% |
| UnitedHealthcare | $41 - $107 | 287% |
| Humana | $41 | 287% |
| Medicare (plans) | $41 | 287% |
| Aetna | $41 - $103 | 287% |
| Blue Cross Blue Shield | $60 | 420% |
| Multiplan | $116 - $119 | 813% |
| Health Partners Of Kansas | $121 | 848% |
| Wppa | $122 | 855% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test (CPT 86803) at Bob Wilson Memorial Hospital in Ulysses, Kansas, the cash median price is $51.00, which is significantly lower than the facility's negotiated rates. While the hospital's negotiated average is $105.00, the cash price offers a more direct comparison to the state average of $60.00. Patients with high-deductible plans or those without insurance may find the cash price advantageous, as it avoids the administrative overhead and markup inherent in insurance billing cycles. It is important to note that while the cash rate is lower than the negotiated average, it is still higher than the Medicare benchmark of $14.27, which serves as the federal baseline for cost.
The data indicates that commercial insurance rates vary widely across payers, ranging from $18 for Centura Employee Plans to $122 for Wppa, with UnitedHealthcare showing the widest spread between their lowest and highest rates. Because the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their network status before scheduling. If a patient chooses to pay out-of-pocket, they should explicitly request a "self-pay" or "prompt-pay" discount at the time of registration, as these upfront fee reductions can further lower the cost. Consumers are advised to demand a full itemized bill rather than accepting a summary invoice, ensuring that all charges are accurate and that no unbundled codes or services not rendered are included in the final amount.