CMS Price Transparency Data

Hepatitis C antibody test

Facility: Methodist Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $38
  • Cash Discount Price: $638
  • vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Methodist Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $638. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.66x the Medicare baseline. Located in 7700 Floyd Curl Dr, San Antonio, TX.
Cash / Self-Pay
$638

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $638 (4471%)
Insurance Median: $38 (266%)
Cash: $638 (4471% of Medicare)
Ins. Median: $38 (266% 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 266% of the Medicare baseline (a markup of 166%). 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.

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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 $12 - $120 84%
Community First Health Plans $12 - $231 84%
United $12 - $384 84%
Usa Managed Care Chip $12 84%
Aetna $13 - $15 91%
Molina Healthcare $13 - $23 91%
Wellmed $13 91%
Blue Cross Blue Shield $14 - $252 98%
Devoted Health $14 98%
Gonzaba Medical Group $14 98%
Ilumed $14 98%
Lighthouse Hospice $14 98%
Triwest $14 98%
Triwest Va Pccc $14 98%
UnitedHealthcare $14 - $854 98%
American Health Plan Of Texas $15 105%
Clover Insurance $15 105%
Humana $15 - $555 105%
Integranet $15 105%
Superior Health $15 - $43 105%
Texas Independent Health Plan $15 105%
Triwest Health Alliance $15 105%
Value Options $15 105%
Wellcare $15 105%
Focus Healthcare Management $20 140%
Superior $23 161%
Cigna $24 - $248 168%
Focus Health Solutions $33 231%
Healthcare Highways $33 231%
Oscar $38 266%
Imperial Insurance $80 - $162 561%
Valenz $148 - $299 1037%
Evry Health $155 - $314 1086%
Fidelis Securecare $190 - $384 1331%
Emerging Therapy Solutions $207 - $572 1451%
Evernorth Behavioral Health $211 - $427 1479%
National Choicecare $211 - $427 1479%
Texas Healthcare Foundation Heb $211 - $427 1479%
Tx Healthcare Foundation $211 - $427 1479%
Healthsmart Preferred Care $232 - $470 1626%
Independent Medical Systems $232 - $470 1626%
Physician Cooperative Of Texas $232 - $470 1626%
Haa Preferred Partners $253 - $512 1773%
San Antonio Employers Health Alliance $253 - $512 1773%
Coastal Comp Health Networks $274 - $555 1920%
National Healthcare Solutions $274 - $555 1920%
Tml Intergovernmental Ebp $295 - $598 2067%
Multiplan $316 - $726 2214%
Usa Managed Care $316 - $683 2214%
Blue Bell $337 - $683 2362%
Directcare America $337 - $683 2362%
Managed Healthcare $358 - $726 2509%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7700 Floyd Curl Dr, San Antonio, TX 78229
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals