CMS Price Transparency Data

Hepatitis C antibody test

Facility: Shannon Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $48
Cash Discount Price: $95
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Shannon Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.36x the Medicare baseline. Located in 120 E Harris Ave., San Angelo, TX.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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: $95 (666%)

Insurance Median: $48 (336%)

Cash: $95 (666% of Medicare)

Ins. Median: $48 (336% 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 336% of the Medicare baseline (a markup of 236%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Care Improvement	$14	98%
Humana	$14 - $151	98%
Wellmed	$14	98%
Molina Healthcare - Chip	$15	105%
Wellpoint	$16 - $19	112%
Scott & White	$22	154%
Cigna	$23	161%
Insurance Management Services	$23	161%
Insurance Services Of Lubbock	$23	161%
City Of San Angelo	$26	182%
Kempton Group	$29	203%
Pdh/Texas Trust	$29	203%
Ambetter / Centene	$31	217%
90 Degree Benefits	$36	252%
Caprock	$36	252%
Blue Cross Blue Shield	$46 - $142	322%
Web Tpa	$85	596%
Aetna	$125	876%
Assurant Health	$125	876%
First Health	$142	995%
UnitedHealthcare	$147	1030%
Healthsmart	$168	1177%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $95.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Shannon Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.