CMS Price Transparency Data

Hepatitis C antibody test

Facility: Oklahoma Heart Hospital, LLC

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $64
Cash Discount Price: $48
vs. Medicare Baseline: 4.48x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Oklahoma Heart Hospital, LLC is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.48x the Medicare baseline. Located in 4050 West Memorial Road, Oklahoma City, OK.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $48 (336%)

Insurance Median: $64 (448%)

Cash: $48 (336% of Medicare)

Ins. Median: $64 (448% 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 448% of the Medicare baseline (a markup of 348%). 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	$13 - $94	91%
Humana	$13 - $94	91%
Blue Cross Blue Shield	$14 - $64	98%
Cigna	$14 - $95	98%
Geha	$14	98%
Medicare (plans)	$14 - $15	98%
UnitedHealthcare	$14	98%
Va Ccn	$14	98%
Veterans Eval Services	$14	98%
Ambetter / Centene	$20	140%
Community Care	$29 - $95	203%
Healthcare Highways	$34 - $82	238%
The Kempton Group	$36	252%
Healthscope	$63	441%
Oscar Insurance Company	$63	441%
Webtpa Chickasaw Nation Hch	$64	448%
Webtpa Hobby Lobby Hch	$72	505%
Coventry	$80	561%
Global Health	$86	603%
Sana Benefits	$88	617%
Ufcw	$88	617%
First Health Network	$94	659%
Manhattan Life	$94	659%
Phcs	$95	666%
Preferred Community Choice	$103	722%
Multiplan	$122	855%

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 $48.
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 Oklahoma Heart Hospital, LLC 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.