CMS Price Transparency Data

Hepatitis C antibody test

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $256
Cash Discount Price: $256
vs. Medicare Baseline: 17.94x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Sarah D Culbertson Memorial Hospital is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 17.94x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.

Cash / Self-Pay

$256

Average discount available for prompt cash payment at this facility.

Insurance Median

$256

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: $256 (1794%)

Insurance Median: $256 (1794%)

Cash: $256 (1794% of Medicare)

Ins. Median: $256 (1794% 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 1794% of the Medicare baseline (a markup of 1694%). 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
Aetna	$30 - $256	210%
Blue Cross Blue Shield	$30 - $278	210%
Corvel-All Plans	$30	210%
Meridian Hp Mcaid-All Plans	$30	210%
Molina Healthcare Mcaid	$30	210%
Humana	$122	855%
Molina Mmai-All Other Plans	$122	855%
UnitedHealthcare	$122 - $256	855%
Cigna	$210	1472%
Beech Street-All Plans	$256	1794%
Encompass-All Plans	$256	1794%
Health Dynamics-All Plans	$256	1794%
Healthlink-All Plans	$256	1794%
Hfn Epo	$256	1794%
Hfn Ppo Ip/Op Only-All Other Plans	$256	1794%
Multiplan/Phcs-All Plans	$256	1794%
Preferred Medical Claims Solution-All Plans	$256	1794%
Three Rivers Provider Network-All Plans	$256	1794%
Wexford Ip/Op Only-All Plans	$256	1794%
Healthsmart-All Plans	$270	1892%

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 $256.
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 Sarah D Culbertson 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.