Hepatitis C antibody test
Facility: Northeast Regional Medical Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $89
- Cash Discount Price: $99
- vs. Medicare Baseline: 6.24x 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 624% of the Medicare baseline (a markup of 524%). 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 |
|---|---|---|
| Tricare | $13 | 91% |
| Medicaid / KanCare | $13 - $21 | 91% |
| Node Champva | $13 | 91% |
| UnitedHealthcare | $14 - $187 | 98% |
| Blue Prefrerred | $14 | 98% |
| Node Hospice Non Par Agree | $14 | 98% |
| Blue Access | $14 | 98% |
| Blue Pathway/Pathway X | $14 | 98% |
| Node VA | $14 | 98% |
| Medicare (plans) | $14 | 98% |
| Blue Cross Blue Shield | $14 - $76 | 98% |
| Veterans Eval Services | $14 | 98% |
| Node Devoted Health McR Adv | $15 | 105% |
| Us Department of Labor | $18 | 126% |
| Centurion Correctional | $18 | 126% |
| Home State Exchange | $26 | 182% |
| Naphcare | $27 | 189% |
| Immergrun | $29 | 203% |
| Self Pay | $60 - $137 | 420% |
| Cigna | $85 - $98 | 596% |
| Aetna | $93 - $208 | 652% |
| Access Health Services, LLC | $162 | 1135% |
| Healthlink | $187 - $200 | 1310% |
| Multiplan | $187 - $200 | 1310% |
| Coventry Wc | $200 | 1402% |
Consumer Guidance & Cost Commentary
For a Hepatitis C antibody test at Northeast Regional Medical Center in Kirksville, MO, the most significant benchmark is the Medicare amount of $14.27, which serves as the federally calculated baseline for this service. The facility's cash price is listed at $99, while the gross chargemaster rate is $250. Notably, the facility's cash rate of $99 is lower than the negotiated rate of $89 for Medicaid/KanCare, illustrating a scenario where paying out-of-pocket can be more economical than using a specific insurance plan. The data indicates that while many commercial payers negotiate rates ranging from $13 to $21, the facility does not provide a specific negotiated rate for Self Pay, though the cash price of $99 remains a key figure for patients considering direct payment.
The facility's pricing structure varies significantly across different payer types, with the highest negotiated rate observed at $208 for Aetna plans and the lowest at $13 for several smaller entities like Node Champva and Tricare. The facility operates as a Proprietary Acute Care Hospital in Kirksville, MO, and the data reflects a vintage of 2026-06. Patients should be aware that while the cash price of $99 is available, many insurance plans negotiate rates that exceed this amount, such as the $140 range seen for Blue Cross Blue Shield and UnitedHealthcare. It is important for consumers to verify if their specific plan has a negotiated rate that is higher than the cash price, as paying the full cash price upfront might result in lower out-of-pocket costs if the insurance deductible has not yet been met or if the allowed amount