CMS Price Transparency Data

Hepatitis C antibody test

Facility: Blount Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $22
Cash Discount Price: $43
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Blount Memorial Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.54x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $43 (301%)

Insurance Median: $22 (154%)

Cash: $43 (301% of Medicare)

Ins. Median: $22 (154% 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.

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
Medicaid / KanCare	$6 - $22	42%
Golden Rule Insurance Company [2991]	$9	63%
Oxford Health Plans [2992]	$9	63%
UnitedHealthcare	$9 - $18	63%
Blue Cross Blue Shield	$10 - $15	70%
Cigna	$11 - $19	77%
Mvp Health Care [3037]	$11	77%
Tricare	$13	91%
Humana	$14	98%
Medicare (plans)	$14 - $15	98%
Ambetter / Centene	$22	154%
Consociate Health Contracted [4835]	$31	217%
Prisma Health Seniorcare Pace - Midlands [5400]	$32	224%
Prisma Health Seniorcare Pace-Upstate [5200]	$32	224%
Fairos/Occunet Contracted [4837]	$33	231%
Promise Health Plan Contracted [2401]	$49 - $83	343%
Orangeburg Senior Helping Center Pace [5401]	$56	392%
Bob Jones Univ-Pai [821]	$83	582%
Preferred Administrators Contracted [2839]	$97	680%
Medcost [2940]	$103 - $115	722%
Atlantic Packaging Contracted [4833]	$104	729%
Aps Healthcare System [2981]	$111	778%
Multiplan/Phcs Contracted [2950]	$124	869%
Aetna	$125	876%
Meritain Health Contracted [2200]	$125	876%
Nippon [2300]	$125	876%
Vsp Vision Care [2986]	$125	876%
First Health Contracted [2952]	$129	904%
Furman Int/Allen University Student [2951]	$129	904%
Quiktrip-First Health [3067]	$129	904%

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 $43.
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 Blount Memorial Hospital 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.