CMS Price Transparency Data

Hepatitis C antibody test

Facility: Hamilton Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $130
  • Cash Discount Price: $138
  • vs. Medicare Baseline: 9.11x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Hamilton Memorial Hospital is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 9.11x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$138

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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: $138 (967%)
Insurance Median: $130 (911%)
Cash: $138 (967% of Medicare)
Ins. Median: $130 (911% 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 911% of the Medicare baseline (a markup of 811%). 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
Medicaid / KanCare $61 - $65 427%
Blue Cross Blue Shield $62 - $148 434%
Aetna $65 - $146 456%
Health Alliance $65 - $130 456%
Humana $65 456%
Medicare (plans) $65 456%
UnitedHealthcare $65 - $117 456%
Wellcare $65 456%
Alliance Coal $114 799%
Healthscope $114 799%
Wellfirst (Ssmhic) $114 799%
Hope Trust $122 855%
Cigna $128 897%
Hfn, Inc $130 - $146 911%
Healthlink $138 - $146 967%
Multiplan $138 967%
Siho $146 1023%
Three Rivers Provider $146 1023%
Healthsmart $155 1086%
Stratose $155 1086%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals