CMS Price Transparency Data

Hepatitis C antibody test

Facility: Lafollette Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Lafollette Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $113 (792%)
Insurance Median: $14 (98%)
Cash: $113 (792% of Medicare)
Ins. Median: $14 (98% 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.

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
Amerigroup $6 42%
Medicaid / KanCare $7 - $14 49%
UnitedHealthcare $7 - $375 49%
Tricare $13 91%
Aetna $14 - $233 98%
Blue Cross Blue Shield $14 - $65 98%
Humana $14 98%
Medicare (plans) $14 98%
Node Blueadvantage Mcr Adv $14 98%
Node Bluecare Plus Tn Mcr Adv $14 98%
Node Champva $14 98%
Node Devoted Health Mcr Adv $14 98%
Node Farm Bureau Mcr Adv $14 98%
Node Healthspring Mcr Adv $14 98%
Node Hospice Non Par Agree $14 98%
Node Va $14 98%
Node Wellcare Mcr Adv $14 98%
Triwest $14 98%
Veterans Eval Services $14 98%
Wellcare $14 98%
Node Amerigroup Mcr Adv $15 105%
Node Nhc Mcr Adv $15 105%
Windsor Health Plan $15 105%
Node Us Dept Of Labor $18 126%
Novanet Work Comp Tn $21 147%
Tn Work Comp $21 147%
Cigna $22 154%
Ambetter / Centene $26 182%
Bluecare $27 - $30 189%
Node Point Comfort Underwriters $31 217%
Self Pay $108 757%
Multiplan Complementary $285 1997%
Beech Street Work Comp Tn $2,120 14856%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals