Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#491 of 11K

86803

Hepatitis C antibody

Hepatitis C antibody is the #491 most-billed Medicaid procedure code, with $187.0M in payments across 23.2M claims from 2018–2024. The national median cost per claim is $10.17. Costs vary widely — the 90th percentile is $20.62 per claim, 2.0× the median.

Total Paid

$187.0M

0.02% of all spending

Total Claims

23.2M

Providers

5K

Avg Cost/Claim

$8

National Cost Distribution

How much do providers bill per claim for 86803? Based on 4K providers billing this code nationally.

Median

$10.17

Average

$15.17

Std Dev

$31.53

Max

$706.12

Percentile Distribution (Cost per Claim)

p10
$1.00
p25
$4.64
Median
$10.17
p75
$14.34
p90
$20.62
p95
$39.97
p99
$164.08

50% of providers bill between $4.64 and $14.34 per claim for this code.

90% bill between $1.00 and $20.62.

Top 1% bill above $164.08.

About This Procedure

HCPCS code 86803 (Hepatitis C antibody) was billed by 5K providers across 23.2M claims, totaling $187.0M in Medicaid payments from 2018–2024. This code was used for 22.1M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.17

Providers Billing

4K

National Spending

$187.0M

Avg/Median Ratio

1.49×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86803

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$8.9M
2Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$8.7M
3Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$6.4M
4Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$6.1M
5Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$6.1M
6Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$5.4M
7Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$4.7M
8Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$3.2M
9Labone Llc

Lenexa, KS · Clinical Medical Laboratory

$3.0M
10Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$2.9M
11Quest Diagnostics Llc

Marlborough, MA · Clinical Medical Laboratory

$2.3M
12Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$1.9M
13Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$1.8M
14Unilab Corporation

Sacramento, CA · Clinical Medical Laboratory

$1.7M
15Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$1.7M
16Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$1.6M
171316983158$1.6M
18Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$1.6M
19Quest Diagnostics Massachusetts Llc

Marlborough, MA · Clinical Medical Laboratory

$1.6M
20Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$1.5M

Showing top 20 of 5K providers billing this code