CMS Price Transparency Data

Hepatitis C antibody test

Facility: The Medical Center of Southeast Texas

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $19
  • Cash Discount Price: $264
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at The Medical Center of Southeast Texas is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.33x the Medicare baseline. Located in 2555 Jimmy Johnson Blvd, Port Arthur, TX.
Cash / Self-Pay
$264

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $264 (1850%)
Insurance Median: $19 (133%)
Cash: $264 (1850% of Medicare)
Ins. Median: $19 (133% 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.

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
UnitedHealthcare $9 - $18 63%
Harbor Hospice $12 84%
Medicaid / KanCare $12 - $14 84%
Superior Healthplan $12 - $14 84%
Texas Childrens Health Plan $12 - $13 84%
Community Health Choice $13 - $17 91%
Community Health Choice Uhrip $13 91%
Humana $13 - $36 91%
Medsolutions $13 91%
Molina Healthcare $13 - $19 91%
Amerigroup $14 - $21 98%
Beacon Health $14 98%
Blue Cross Blue Shield $14 - $109 98%
Caresact $14 98%
Employer Direct Healthcare $14 - $18 98%
Healthspring $14 98%
Hospice $14 98%
Medicare (plans) $14 98%
Provider Partners Health Plan $14 98%
Rice Land Hospice $14 98%
Selectcare $14 98%
Texas Medical Management Partners $14 - $18 98%
Tihp (Texas Independence Health Plan) $14 98%
Triwest $14 98%
Cccn Pro Advantage $15 105%
Cigna $15 - $185 105%
League Medical Concepts $15 105%
Tricare $15 105%
Wellcare Of Texas $15 105%
Wellpath $16 112%
Corporate Remedies $21 147%
Elap Services $28 196%
Texas Workers Compensation $29 203%
Self Pay Emergent $40 280%
Dept Of Assistive And Rehabilitative Services $132 925%
Aetna $153 - $174 1072%
Iasis Employees $158 1107%
Magellan Behavioral Health $158 1107%
First Health $185 1296%
Galaxy Health Network $185 1296%
Private Healthcare Systems $185 1296%
Texas Municipal League $185 1296%
Healthsmart $198 1388%
Multiplan $211 1479%
Commercial Non-Contracted $264 1850%
Heart To Heart Hospice $264 1850%
Lifesynch $264 1850%
Mhnet $264 1850%
Self Pay - Mcd Pending 100 Percent $264 1850%
Single Case Agreement $264 1850%
United Behavioral Health $264 1850%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640
  • CMS Rating: ★★★☆☆
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals