CMS Price Transparency Data

Hepatitis C antibody test

Facility: Cannon Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $97
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 6.80x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Cannon Memorial Hospital is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.80x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$81

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $81 (568%)
Insurance Median: $97 (680%)
Cash: $81 (568% of Medicare)
Ins. Median: $97 (680% 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 680% of the Medicare baseline (a markup of 580%). 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 $10 70%
Mail Handlers Benefit Plan [327] $10 70%
Rural Carrier Benefit Plan [406] $10 70%
Blue Cross Blue Shield $18 - $153 126%
Medicaid / KanCare $18 - $161 126%
Other Hospital Payers [1991] $18 - $161 126%
Planned Administrators [886] $18 - $82 126%
Select Health Of Sc [637] $18 126%
Absolute Total Care [58] $19 133%
Humana $19 - $116 133%
Employee Benefit Management Services [869] $45 315%
Blue Choice Health Plan [922] $46 - $92 322%
Thomas Cooper & Company [315] $82 575%
Geha [302] $86 603%
Golden Rule Ins Co [584] $86 603%
UnitedHealthcare $86 - $161 603%
Phcs [940] $87 - $106 610%
Cigna $96 - $161 673%
Nalc Health Benefit Plan [291] $96 673%
Medcost [206] $97 - $145 680%
Preferred Administrators [19] $97 680%
Coventry Health [245] $101 - $116 708%
American Continental Ins [778] $161 1128%
American Republic Life Ins [722] $161 1128%
Business Office [6000] $161 1128%
Covid19 Hrsa Uninsured Testing And Treatment Fund [17] $161 1128%
First Health [946] $161 1128%
Guarantee Trust Life Insurance [236] $161 1128%
Home Health Infusion Payer [6001] $161 1128%
Manhattan Life Ins Co [932] $161 1128%
Medicare (plans) $161 1128%
Miscellaneous Commercial [1] $161 1128%
New Era Life Ins Co [437] $161 1128%
Non-Contracted [22] $161 1128%
Physicians Mutual [773] $161 1128%
Reference Based Pricing/Limited Plan [21] $161 1128%
State Farm Ins Co [373] $161 1128%
Sterling Investors Life [244] $161 1128%
Supermed/Med Mutual Of Ohio [539] $161 1128%
United American Ins Co [277] $161 1128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 123 W G Acker Drive, Pickens, SC 29671
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals