Hepatitis C antibody test
Facility: Charleston Area Medical Center
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $209
- Cash Discount Price: $239
- vs. Medicare Baseline: 14.65x 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 1465% of the Medicare baseline (a markup of 1365%). 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 |
|---|---|---|
| The Health Plan of West Virginia Inc. | $13 - $242 | 91% |
| Unicare Health Plan of West Virginia Inc. | $13 | 91% |
| Aetna | $13 - $244 | 91% |
| Choicecare Network | $14 - $244 | 98% |
| Optimum Choice Inc. | $14 | 98% |
| Blue Cross Blue Shield | $14 - $227 | 98% |
| Triwest VA | $14 | 98% |
| UnitedHealthcare | $15 - $244 | 105% |
| West Virginia Senior Advantage Inc. | $15 | 105% |
| Integrated Medical Solutions | $28 | 196% |
| Naphcare | $29 | 203% |
| Caresource | $36 | 252% |
| Tricare | $137 - $149 | 960% |
| City of Charleston | $172 - $187 | 1205% |
| Cigna | $213 - $232 | 1493% |
| Three Rivers Providers Network | $222 - $242 | 1556% |
| Multiplan | $224 - $244 | 1570% |
| Healthsmart | $224 - $244 | 1570% |
Consumer Guidance & Cost Commentary
For a Hepatitis C antibody test at Charleston Area Medical Center in Charleston, WV, the cash median rate is $239. This facility, a voluntary non-profit acute care hospital, lists a gross charge of $239, which matches the cash median. While the median negotiated rate across payers is $209, patients with high-deductible plans may find that paying the cash price of $239 upfront is more cost-effective than relying on insurance, especially since some negotiated rates can exceed the cash amount. It is advisable to contact the hospital directly to confirm if self-pay or prompt-pay discounts are available before scheduling.
This service is significantly more expensive than the Medicare benchmark, which is set at $14.27, representing a markup of 14.6 times the Medicare amount. Commercial insurance allows vary widely, with high-end rates reaching up to $28 for some plans and low-end rates as low as $13 for others. Because balance billing is generally prohibited for emergency services and non-emergency services from out-of-network providers at in-network facilities under the No Surprises Act, patients should request a full itemized billing audit to identify any unbundled codes or services not rendered. Disputing errors in writing is the most effective way to reduce medical debt, as over 80% of hospital bills contain inaccuracies.