CMS Price Transparency Data

Hepatitis C antibody test

Facility: Lake Granbury Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $38
  • Cash Discount Price: $191
  • vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Lake Granbury Medical Center is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.66x the Medicare baseline. Located in 1310 Paluxy Rd, Granbury, TX.
Cash / Self-Pay
$191

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: $191 (1338%)
Insurance Median: $38 (266%)
Cash: $191 (1338% 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.

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
Aetna $14 - $584 98%
Blue Cross Blue Shield $14 - $214 98%
Cigna $14 - $335 98%
Hospice Non Par $14 98%
Humana $14 98%
Medicare (plans) $14 98%
Node Care N Care $14 98%
Node Va $14 98%
Triwest $14 98%
UnitedHealthcare $14 - $361 98%
Veterans Eval Services $14 98%
American Health $15 105%
Node Amerigroup Mcr Adv $15 105%
Node Champva $15 105%
Provider Partners Health Plan $15 105%
Superior $15 - $39 105%
Tricare $15 105%
Node Us Dept Of Labor $18 126%
Medicaid / KanCare $20 - $437 140%
Healthspring $21 147%
Node Brookshire Brothers $25 175%
93% Payors Work Comp Tx $27 189%
Node Brookshire Brothers Work Comp Tx $27 189%
Work Comp $29 203%
Self Pay $51 - $94 357%
Amerigroup $121 848%
Healthsmart $468 - $595 3280%
Multiplan $638 - $748 4471%
Santa Fe Hospital Association $680 4765%
Galaxy Health $808 5662%
Medcorp Southwest $808 5662%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1310 Paluxy Rd, Granbury, TX 76048
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals