CMS Price Transparency Data

Hepatitis C antibody test

Facility: Gibson General Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $125
  • Cash Discount Price: $228
  • vs. Medicare Baseline: 8.76x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Gibson General Hospital is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.76x the Medicare baseline. Located in 1808 Sherman Drive, Princeton, IN.
Cash / Self-Pay
$228

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $228 (1598%)
Insurance Median: $125 (876%)
Cash: $228 (1598% of Medicare)
Ins. Median: $125 (876% 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 876% of the Medicare baseline (a markup of 776%). 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
Blue Cross Blue Shield $6 - $138 42%
UnitedHealthcare $9 - $302 63%
Aetna $14 - $337 98%
Alliance Coal $14 - $108 98%
Ambetter / Centene $14 - $138 98%
Caresource $14 98%
Caresource Just For Me $14 - $138 98%
Mdwise Plans $14 98%
Medicaid / KanCare $14 98%
Medicare (plans) $14 - $138 98%
Meridiancare (Il) $14 - $138 98%
Meridiancomplete (Il) $14 - $138 98%
Meridianhealth (Il) $14 98%
Mhs $14 98%
Mytruadvantage $14 - $138 98%
Va Ccn $14 - $138 98%
Caresource In Marketplace $19 - $239 133%
Deaconess Onecare $19 - $358 133%
Claimdoc $20 - $366 140%
Hopetrust $21 - $366 147%
Hstechnology $21 - $366 147%
Encircle/Encore Combined $22 - $366 154%
Encircle/Encore Prime $22 - $323 154%
Noncontracted $23 - $221 161%
Cigna $26 - $379 182%
First Health $26 - $388 182%
Healthlink Hmo $26 - $388 182%
Healthlink Ppo $26 - $388 182%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+) $26 - $379 182%
Ky Racing Health & Welfare Fund $43 - $233 301%
Self-Pay $43 - $228 301%
Chambercare $74 - $345 519%
Gibson County Sheriff $105 - $366 736%
Integrated Health $112 - $388 785%
Principal Health Care $112 - $388 785%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1808 Sherman Drive, Princeton, IN 47670
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals