CMS Price Transparency Data

Hepatitis C antibody test

Facility: Sarah Bush Lincoln Health Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $85
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 5.96x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Sarah Bush Lincoln Health Center is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.96x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $115 (806%)
Insurance Median: $85 (596%)
Cash: $115 (806% of Medicare)
Ins. Median: $85 (596% 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 596% of the Medicare baseline (a markup of 496%). 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.

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
Aetna $12 - $104 84%
Bc Comm Care Mcaid $12 84%
Hlth Alliance Mcaid $12 84%
Meridian Mcaid $12 84%
Molina Mcaid $12 84%
Bc Comm Mmai $14 98%
Beacon Health Options Behav-All Plans $14 98%
Hlth Alliance Mcr Adv $14 98%
Humana $14 - $15 98%
Meridian Mmai-All Other Plans $14 98%
Molina Mmai-All Other Plans $14 98%
Tricare $14 98%
UnitedHealthcare $14 - $95 98%
Va Ccn-All Plans $14 98%
Wellcare Med Adv-All Plans $14 98%
Bc Med Adv Ppo/Hmo $15 105%
Plain Church Mg-All Plans $46 322%
Mennonite-All Plans $52 364%
Eiu Athlete-All Other Plans $80 561%
Healthscope-All Plans $85 596%
Rural King-All Plans $85 596%
Blue Cross Blue Shield $91 - $92 638%
Consociate-All Plans $92 645%
Hope Trust-All Plans $92 645%
Eiu Student $94 659%
Allied National-All Plans $97 680%
Companion Life-All Plans $97 680%
Hlth Alliance-All Other Plans $97 680%
First Health-All Plans $98 687%
Innovative Hlthware-All Plans $98 687%
Healthlink Hmo $99 694%
Healthlink Ppo - All Other Plans $99 694%
Multiplan-All Plans $99 694%
Cigna $104 729%
Cphp-All Plans $104 729%
Beech Street-All Plans $106 743%
Hfn-All Plans $106 743%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals