Hepatitis C antibody test
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $148
- Cash Discount Price: $197
- vs. Medicare Baseline: 10.37x 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 1037% of the Medicare baseline (a markup of 937%). 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 | $118 | 827% |
| Americas Choice Provider Network | $138 | 967% |
| Velocity | $148 | 1037% |
| Provider Network Of America | $148 | 1037% |
| Quiktrip Corporation | $148 | 1037% |
| Usa Managed Care Organization | $148 | 1037% |
| Multiplan-Phcs | $158 | 1107% |
| Prime Health Services | $168 | 1177% |
| Medincrease | $178 | 1247% |
Consumer Guidance & Cost Commentary
For the Hepatitis C antibody test at the Rehabilitation Hospital Of Overland Park, the cash price is $197.00, which matches the facility's negotiated rate of $148.00 and the state average of $148.00. While the facility's cash price is higher than the negotiated rate, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allows a higher amount than the cash price. It is important to note that the facility's cash price is significantly higher than the Medicare benchmark of $14.27, illustrating how commercial rates often exceed federal cost baselines. Patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs compared to paying cash directly.
This service is subject to balance billing if the patient receives care from an out-of-network provider, where the provider bills the difference between their full chargemaster rate and the insurance allowed amount. However, the No Surprises Act protects patients from such surprise bills for emergency care and non-emergency services at in-network facilities. If a patient receives an unexpected bill, they should dispute it with their insurer and request a No Surprises Act audit rather than paying immediately. Additionally, patients should request a full itemized CPT-coded bill before paying, as summary bills can obscure errors or unbundled charges. Finally, patients should ask the hospital about prompt-pay discounts, which can reduce the total cost by paying in full upfront, bypassing the administrative costs associated with insurance claims processing.