CMS Price Transparency Data

Hepatitis C antibody test

Facility: Methodist Hospitals Inc

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $22
  • Cash Discount Price: $436
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Methodist Hospitals Inc is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.54x the Medicare baseline. Located in 600 Grant St, Gary, IN.
Cash / Self-Pay
$436

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $436 (3055%)
Insurance Median: $22 (154%)
Cash: $436 (3055% of Medicare)
Ins. Median: $22 (154% 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.

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 $14 - $461 98%
Blue Cross Blue Shield $14 - $537 98%
Caresource $14 98%
Humana $14 98%
Managed Health Services $14 98%
Medicaid / KanCare $14 98%
Medicare (plans) $14 98%
United Heathcare $14 98%
UnitedHealthcare $14 - $21 98%
Zing $15 105%
Caresource Maketplace $24 168%
Ambetter / Centene $29 203%
Magnacare $38 266%
Physicians Health Plan Of Northern Indiana $43 301%
Cigna $239 - $260 1675%
Encore $374 - $554 2621%
Phcs $424 2971%
Siho $436 3055%
Sagamore $449 3146%
Multiplan $455 3189%
Hfn $486 - $530 3406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Grant St, Gary, IN 46402
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals