CMS Price Transparency Data

Hepatitis C antibody test

Facility: Tristar Northcrest Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $15
  • Cash Discount Price: $303
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Tristar Northcrest Medical Center is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $303. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 100 Northcrest Drive, Springfield, TN.
Cash / Self-Pay
$303

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $303 (2123%)
Insurance Median: $15 (105%)
Cash: $303 (2123% of Medicare)
Ins. Median: $15 (105% 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
Wellpoint $6 42%
Aetna $11 - $152 77%
Alive Hospice $14 98%
Amerigroup $14 98%
Bright Health $14 - $16 98%
Devoted Health Plan $14 98%
Healthspring $14 98%
Humana $14 - $57 98%
Molina $14 98%
United $14 - $137 98%
Wellcare $14 - $19 98%
Ambetter / Centene $15 105%
American Health Advantage $15 105%
Blue Cross Blue Shield $15 - $19 105%
Evergreen Hmo $15 105%
Zing $15 105%
Atrio Golden Times $16 112%
Novanet $21 147%
Prime Health $21 147%
Cigna $25 - $89 175%
Oscar $43 301%
Nhc Advantage, Inc. $58 406%
City Of Springfield $197 1381%
Multiplan $237 - $249 1661%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Northcrest Drive, Springfield, TN 37172
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals