Hepatitis C antibody test
Facility: Golden Valley Memorial Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $178
- 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 |
|---|---|---|
| Aetna | $14 | 98% |
| Home State Health | $14 | 98% |
| Humana | $14 | 98% |
| UnitedHealthcare | $14 - $24 | 98% |
| Ambetter / Centene | $17 | 119% |
Consumer Guidance & Cost Commentary
Golden Valley Memorial Hospital, located in Clinton, Missouri, charges a cash median rate of $178 for the Hepatitis C antibody test. This cash price is significantly lower than the facility's gross chargemaster rate of $297 and represents a substantial discount compared to the national average. While the facility's negotiated rates with major payers like Aetna, Home State Health, and Humana are set at $14, and UnitedHealthcare ranges from $14 to $24, these insurance amounts are notably lower than the cash price. Patients with high-deductible plans or those paying out-of-pocket may find the cash rate more advantageous, provided they verify if their specific insurance plan's negotiated rate exceeds the $178 self-pay amount.
It is important to note that the facility's cash rate differs from the state and county averages, which are not included in this specific price transparency dataset. The Medicare benchmark for this service is $14.27, indicating that the cash price is higher than the federal government's calculated cost basis. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency care at in-network facilities, unexpected charges can still occur for ancillary services. To minimize costs, individuals should explicitly request a "self-pay" or "prompt-pay" discount at registration, as hospitals often offer additional reductions for upfront payment that are not reflected in the standard cash median. Always ensure you receive an itemized bill before paying to verify that no unbundled codes or services not rendered have been included in the final charge.