CMS Price Transparency Data

Hepatitis C antibody test

Facility: Alliancehealth Madill

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $61
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 4.27x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Alliancehealth Madill is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.27x the Medicare baseline. Located in 901 S 5Th Ave, Madill, OK.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$61

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: $74 (519%)
Insurance Median: $61 (427%)
Cash: $74 (519% of Medicare)
Ins. Median: $61 (427% 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 427% of the Medicare baseline (a markup of 327%). 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
Aetna $13 - $226 91%
Humana $13 - $58 91%
Medicaid / KanCare $13 91%
Node Us Dept Of Labor $18 126%
Healthchoice $19 133%
Blue Cross Blue Shield $21 - $60 147%
Preferred Community Choice Ppo $21 - $42 147%
UnitedHealthcare $25 - $59 175%
Medicare (plans) $29 - $58 203%
Node Global Health Mcr Adv $29 - $58 203%
Node Indian Health Service Managed Care $29 - $59 203%
Node Va $29 - $137 203%
Node Champva $30 - $61 210%
Tricare $30 - $61 210%
Self Pay $49 - $99 343%
Coventry $70 - $142 491%
Globalhealth $87 - $175 610%
Healthcare Highways $88 - $177 617%
Phcs $98 - $198 687%
Multiplan $105 - $221 736%
First Health $115 - $232 806%
Cigna $119 - $241 834%
Evolutions Healthcare Systems $119 - $241 834%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 S 5Th Ave, Madill, OK 73446
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals