CMS Price Transparency Data

Hepatitis C antibody test

Facility: St Jude Childrens Research Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $37
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.59x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at St Jude Childrens Research Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.59x the Medicare baseline. Located in 262 Danny Thomas Place, Memphis, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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%)

Insurance Median: $37 (259%)

Ins. Median: $37 (259% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 259% of the Medicare baseline (a markup of 159%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$10 - $81	70%
Home State Health	$13	91%
Medicaid / KanCare	$13 - $14	91%
Healthcare Connections La	$14	98%
Healthy Blue	$14	98%
Health Choice - Ok	$18	126%
Molina Marketplace Of Ms	$19 - $21	133%
Empower	$20	140%
Blue Cross Blue Shield	$27 - $46	189%
Tenncare Select Hmo	$29	203%
Vantage	$67 - $75	470%
Humana	$73	512%
Aetna	$84	589%
Private Health Care Systems	$90	631%
Ms Physicians Care Network	$95	666%
Baptist Health	$101	708%
Cigna	$101	708%
First Health Ccn	$101	708%
Health Choice	$101	708%
Health Link Mississippi	$101	708%
Healthscope Benefits Inc	$101	708%
Tricare	$112	785%

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 $X.
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 St Jude Childrens Research 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.