CMS Price Transparency Data

Hepatitis C antibody test

Facility: Frankfort Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $199
Cash Discount Price: $904
vs. Medicare Baseline: 13.95x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Frankfort Regional Medical Center is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $904. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 13.95x the Medicare baseline. Located in 299 Kings Daughters Drive, Frankfort, KY.

Cash / Self-Pay

$904

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $904 (6335%)

Insurance Median: $199 (1395%)

Cash: $904 (6335% of Medicare)

Ins. Median: $199 (1395% 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 1395% of the Medicare baseline (a markup of 1295%). 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
Blue Cross Blue Shield	$12 - $14	84%
Aetna	$14	98%
Coventry Cares	$14	98%
Devoted Health	$14	98%
Humana	$14 - $270	98%
Molina	$14	98%
United	$14 - $439	98%
United Behavioral Health	$14	98%
United Va	$14	98%
Wellcare	$14 - $16	98%
Horizon Pace	$15	105%
Corvel	$116 - $157	813%
Prime Health	$116 - $157	813%
Signature Advantage	$137 - $186	960%
Cigna	$212 - $287	1486%
Essence Healthcare	$324 - $439	2270%
Baptist Health Network	$389 - $527	2726%
Hospice Of Central Kentucky	$454 - $615	3181%
Occupational Mc Alliance	$577 - $781	4043%
Multiplan	$685 - $928	4800%

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 $904.
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 Frankfort Regional Medical Center 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.