CMS Price Transparency Data

Hepatitis C antibody test

Facility: Holmes County Hospital and Clinics

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $92
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 6.45x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Holmes County Hospital and Clinics is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.45x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $49 (343%)
Insurance Median: $92 (645%)
Cash: $49 (343% of Medicare)
Ins. Median: $92 (645% 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 645% of the Medicare baseline (a markup of 545%). 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
Ms-Can-Magnolia-Lex $13 91%
Ms-Can-Molina-Lex $13 91%
Ms-Can-Truecare-Lex $13 91%
United-Lex $24 168%
United-Options-Lex $24 168%
Molina-Chip-Lex $28 196%
Magnolia-Chip-Lex $29 203%
Truecare-Chip-Lex $29 203%
Cigna $71 498%
Tricare $75 526%
Humana $76 533%
Mpcn-Lex $79 554%
Medadv_Uhc-Lex $83 582%
Firstchoice-Lex $85 596%
Advhealth-Lex $92 645%
Ambetter / Centene $92 645%
Medadv_Primewell-Lex $92 645%
Medicare (plans) $92 645%
Primewell-Lex $92 645%
Va_Ccn-Lex $92 645%
Medadv_Uhcdsnp-Lex $94 659%
Wellcare-Lex $94 659%
Ppoplus $95 666%
Devoted_Health-Lex $96 673%
Blue Cross Blue Shield $98 687%
Firsthealth-Lex $98 687%
Multiplan-Lex $98 687%
Aetna $104 729%
Phcs-Lex $110 771%
Molina_Exchange-Lex $122 855%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals