CMS Price Transparency Data

Hepatitis C antibody test

Facility: Tristar Summit Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $16
  • Cash Discount Price: $190
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Tristar Summit Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.12x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.
Cash / Self-Pay
$190

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: $190 (1331%)
Insurance Median: $16 (112%)
Cash: $190 (1331% 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
Wellpoint $6 42%
Aetna $11 - $95 77%
Amerigroup $14 98%
Bright Health $14 - $16 98%
Devoted Health Plan $14 98%
Healthspring $14 98%
Humana $14 - $124 98%
Odyssey Healthcare $14 98%
Sarah Cannon Research $14 98%
United $14 - $86 98%
Ambetter / Centene $15 105%
American Health Advantage $15 105%
Blue Cross Blue Shield $15 - $72 105%
Evergreen Hmo $15 105%
Signature Advantage $15 105%
Wellcare $15 105%
Zing $15 105%
Atrio Golden Times $16 112%
Corvel Corporation $21 147%
Novanet $21 147%
Prime Health $21 - $167 147%
Cigna $25 - $152 175%
Kentucky Labor Cabinet $35 245%
Apex Health $36 252%
Nhc Advantage, Inc. $36 252%
Pruitt Health (Allyalign) $36 252%
Oscar $43 301%
Centurion $78 547%
Bgfh Singlesource $95 - $162 666%
Multiplan $124 869%
Employers Health Network $133 932%
Odom'S Tn Pride Sausage $142 995%
Compsych $152 1065%
Beech Street $167 1170%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5655 Frist Blvd, Hermitage, TN 37076
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals