CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Houston Healthcare Northwest

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $15
Cash Discount Price: $3,111
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Houston Healthcare Northwest is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,111. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 710 Cypress Creek Parkway, Houston, TX.

Cash / Self-Pay

$3,111

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $3,111 (21801%)

Insurance Median: $15 (105%)

Cash: $3,111 (21801% of Medicare)

Ins. Median: $15 (105% 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.

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
Community Health Choice Mcd	$12	84%
Texas Childrens Health Plans	$12 - $516	84%
United	$12 - $1,400	84%
Aetna	$13 - $94	91%
Molina Healthcare	$13 - $31	91%
Blue Cross Blue Shield	$14 - $1,089	98%
Cigna	$14 - $75	98%
Devoted Health	$14	98%
Humana	$14 - $191	98%
Oscar	$14 - $41	98%
Triwest Healthcare Alliance	$14 - $43	98%
Van Lang Ipa	$14	98%
Wellmed	$14	98%
American Health Plan	$15	105%
Christus (Usfhp)	$15	105%
Integranet Amerigroup Ipa	$15	105%
Procare Advantage	$15	105%
Provider Partners Health Plan Of Texas	$15	105%
Shared Health	$15	105%
Superior Health Plan	$15 - $187	105%
Triwest Health Alliance	$15	105%
Wellcare	$15	105%
Molina	$16	112%
Verda Health Plan	$19	133%
Community Health Choice	$21	147%
Superior	$21 - $22	147%
Healthcare Highways	$43	301%
Evry Health	$849	5950%
Coventry National First Health	$1,658	11619%

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 $3,111.
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 HCA Houston Healthcare Northwest 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.