CMS Price Transparency Data

Hepatitis C antibody test

Facility: St David's Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $56
  • Cash Discount Price: $803
  • vs. Medicare Baseline: 3.92x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St David's Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $803. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.92x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
$803

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $803 (5627%)
Insurance Median: $56 (392%)
Cash: $803 (5627% of Medicare)
Ins. Median: $56 (392% 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 392% of the Medicare baseline (a markup of 292%). 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
St David’S Hospice $12 - $14 84%
United $12 - $505 84%
Blue Cross Blue Shield $13 - $358 91%
Molina Healthcare $13 - $16 91%
Aetna $14 - $15 98%
Cigna $14 - $40 98%
Devoted Health $14 98%
Humana $14 - $15 98%
Odyssey Hospice $14 98%
Triwest Healthcare Alliance $14 98%
Triwest Veterans $14 98%
Wellmed $14 98%
American Health Plan Of Texas $15 105%
Provider Partners Health Plan $15 105%
Pyramid Life $15 105%
Sendero $15 - $24 105%
Shared Health $15 105%
Superior Health Plan $15 - $191 105%
Texas Independent Health Plan $15 105%
Triwest Health Alliance $15 - $16 105%
Wellcare $15 105%
Imperial Insurance $16 112%
Universal Health $17 119%
Austin Fc $18 126%
Amerigroup $20 140%
Naphcare $22 154%
Seven Corners $22 154%
Corvel Corporation $28 196%
Oscar $39 - $44 273%
Moda $114 - $264 799%
Covenant Management Systems $139 - $323 974%
Healthcare Highways $141 - $337 988%
Imo Med - Select Network $145 - $337 1016%
Nomi Health $155 - $416 1086%
Moda Health $174 - $416 1219%
Evry Health $178 - $413 1247%
Texas Healthcare Foundation Heb $179 - $416 1254%
Texas Workforce Commission $188 - $438 1317%
Harbor Health Team $193 - $449 1352%
Averde Health $217 - $505 1521%
Comanche County $242 - $562 1696%
Healthsmart Preferred Care $266 - $898 1864%
Independent Medical Systems $266 - $618 1864%
Physicians Cooperative Of Texas $266 - $618 1864%
Prime Health $290 - $674 2032%
First Health $304 - $807 2130%
Coastal Comp Health Networks $314 - $730 2200%
National Health Care $314 - $730 2200%
Medcorp Southwest $362 - $842 2537%
Beech Street $435 - $1,011 3048%
Medical Control Network Solutions $435 - $1,011 3048%
Multiplan $435 - $1,011 3048%
National Choicecare $562 3938%
Occunet $786 5508%
Texas Municipal League $786 5508%
Rockport Healthcare Group $898 - $1,011 6293%
Bce Emergis Corporation $1,011 7085%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals