CMS Price Transparency Data

Hepatitis C antibody test

Facility: Community Hospital of Staunton

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $138
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 9.67x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Community Hospital of Staunton is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 9.67x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $92 (645%)
Insurance Median: $138 (967%)
Cash: $92 (645% of Medicare)
Ins. Median: $138 (967% 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 967% of the Medicare baseline (a markup of 867%). 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
Tricare $13 - $53 91%
Clear Spring Health Ma $14 - $56 98%
Medicare (plans) $14 - $55 98%
Medicaid / KanCare $19 - $184 133%
Self Pay $92 645%
UnitedHealthcare $96 - $184 673%
Cigna $119 834%
Blue Cross Blue Shield $138 - $184 967%
Healthlink $138 - $157 967%
Health Alliance Commercial $148 - $184 1037%
Aetna $149 - $184 1044%
Multiplan/Phcs $157 1100%
Beech Street $168 1177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Caldwell St, Staunton, IL 62088
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals