CMS Price Transparency Data

Hepatitis C antibody test

Facility: Physicians Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $16
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Physicians Regional Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.12x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $83 (582%)
Insurance Median: $16 (112%)
Cash: $83 (582% of Medicare)
Ins. Median: $16 (112% 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 - $15 42%
Amerigroup Community Care $6 42%
Medicaid / KanCare $7 49%
UnitedHealthcare $7 - $375 49%
Tricare $13 91%
Aetna $14 - $52 98%
Blue Cross Blue Shield $14 - $73 98%
Department Of Veterans Affairs $14 98%
Humana $14 98%
Medicare (plans) $14 98%
Node Bluecare Plus Tn Mcr Adv $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%
Veterans Eval Services $14 98%
Node Nhc Mcr Adv $15 105%
Wellcare $15 105%
Node Us Dept Of Labor $18 126%
Us Department Of Labor $18 126%
Novanet Work Comp Tn $21 147%
Occunet Work Comp Tn $21 147%
Tn Work Comp $21 147%
Cigna $22 154%
Ambetter / Centene $26 182%
Node Point Comfort Underwriters $26 182%
Self Pay $82 - $85 575%
Multiplan $203 - $267 1423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals