CMS Price Transparency Data

Hepatitis C antibody test

Facility: Fhn Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $38
Cash Discount Price: $39
vs. Medicare Baseline: 2.66x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Fhn Memorial Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.66x the Medicare baseline. Located in 1045 West Stephenson Street, Freeport, IL.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $39 (273%)

Insurance Median: $38 (266%)

Cash: $39 (273% of Medicare)

Ins. Median: $38 (266% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 266% of the Medicare baseline (a markup of 166%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Meridian Health Plan - All Plans	$8	56%
Aetna	$14 - $27	98%
Health Alliance Mcr Adv	$14	98%
Humana	$14 - $38	98%
Quartz Mcr Adv	$14	98%
UnitedHealthcare	$14 - $38	98%
The Alliance - All Plans	$29	203%
Ecoh Nihp	$30	210%
Nihp Employ - All Plans	$30	210%
Quartz - All Other Plans	$31	217%
Blue Cross Blue Shield	$33	231%
Ecoh - All Other Plans	$33	231%
Northern Il Hp - All Plans	$33	231%
First Health - All Plans	$34	238%
Hfn - All Plans	$39 - $40	273%
First Choice Il - All Plans	$41	287%
Multiplan Phcs - All Plans	$41	287%
Wps - All Plans	$42	294%
Galaxy - All Plans	$43	301%
Health Alliance - All Other Plans	$43	301%
Interplan Health - All Plans	$43	301%
Preferred Plan Ppo - All Plans	$43	301%
Trustmark - All Plans	$44	308%
Midland Choice - All Plans	$46	322%
Osf Healthplans - All Plans	$48	336%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $39.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fhn Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.