CMS Price Transparency Data

Hepatitis C antibody test

Facility: Texoma Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $91
  • Cash Discount Price: $244
  • vs. Medicare Baseline: 6.38x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Texoma Medical Center is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.38x the Medicare baseline. Located in 5016 S Us Highway 75, Denison, TX.
Cash / Self-Pay
$244

Average discount available for prompt cash payment at this facility.

Insurance Median
$91

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: $244 (1710%)
Insurance Median: $91 (638%)
Cash: $244 (1710% of Medicare)
Ins. Median: $91 (638% 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 638% of the Medicare baseline (a markup of 538%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Molina $12 - $231 84%
Superior $13 - $26 91%
Tchp $13 91%
Amerigroup $19 133%
United_Healthcare $19 133%
Aetna $91 638%
Cigna $120 - $129 841%
Healthsmart $189 - $244 1324%
Humana $189 1324%
Multiplan $231 1619%
Healthchoice $244 1710%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5016 S Us Highway 75, Denison, TX 75020
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals