CMS Price Transparency Data

Hepatitis C antibody test

Facility: St Marys Good Samaritan Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $22
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St Marys Good Samaritan Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.54x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14.27 (100%)
Cash / Self-Pay: $49 (343%)
Insurance Median: $22 (154%)
Cash: $49 (343% of Medicare)
Ins. Median: $22 (154% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $13 - $60 91%
Aetna $18 - $66 126%
Ambetter / Centene $18 - $22 126%
Amerigroup $18 126%
Care Improvement Plus $18 - $22 126%
Caresource $18 - $22 126%
Cigna $18 - $68 126%
Coventry $18 - $62 126%
Eon Health Plan $18 - $22 126%
Humana $18 - $62 126%
Kaiser Permanente $18 - $22 126%
Molina $18 - $22 126%
Pruitthealth Premier $18 - $22 126%
Todays Options Pffs $18 - $22 126%
Todays Options Ppo $18 - $22 126%
UnitedHealthcare $18 - $2,632 126%
Vaccn United $18 - $22 126%
Wellcare $18 - $22 126%
First Health $51 - $62 357%
Phcs $51 - $62 357%
Meritain $54 - $66 378%
Multiplan $58 - $72 406%
Nova $58 - $75 406%
Three Rivers Provider Network $61 - $75 427%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5401 Lake Oconee Parkway, Greensboro, GA 30642
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals