CMS Price Transparency Data

Hepatitis C antibody test

Facility: Matagorda Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $71
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Matagorda Regional Medical Center is $71. 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 4.98x the Medicare baseline. Located in 104 7Th Street, Bay City, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

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: $71 (498%)
Ins. Median: $71 (498% 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 498% of the Medicare baseline (a markup of 398%). 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
Aetna $14 - $80 98%
Humana $14 - $83 98%
Medicare (plans) $14 98%
Triwest $14 98%
United $14 98%
Wellcare $14 98%
UnitedHealthcare $16 - $88 112%
Am Better $17 119%
Alliance $20 140%
Corvel $29 203%
Blue Cross Blue Shield $43 - $126 301%
Comm Care $71 498%
Medicaid / KanCare $71 498%
Molina $71 498%
Scott & White $71 498%
Superior $71 498%
Tcstar $71 498%
Wellpoint $71 498%
Coventry First Health $89 624%
Galaxy Health $89 624%
Cigna $95 666%
Independent Medical System $108 757%
Multiplan Phcs $108 757%
Three Rivers $108 757%
Health Smart $114 799%
Usa Managed $114 799%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 104 7Th Street, Bay City, TX 77414
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals