CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Houston Healthcare West

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $17
  • Cash Discount Price: $1,490
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Houston Healthcare West is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,490. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.19x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$1,490

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $1,490 (10441%)
Insurance Median: $17 (119%)
Cash: $1,490 (10441% of Medicare)
Ins. Median: $17 (119% 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
Amerigroup $12 - $14 84%
Community Health Choice Mcd $12 84%
Texas Childrens Health Plans $12 - $247 84%
Texas Health Network $12 84%
United $12 - $670 84%
Aetna $13 - $94 91%
Molina Healthcare $13 - $31 91%
Blue Cross Blue Shield $14 - $522 98%
Chc Harris Health $14 98%
Cigna $14 - $1,192 98%
Devoted Health $14 98%
Humana $14 - $191 98%
Kelsey Seybold $14 98%
Oscar $14 - $41 98%
Renaissance Ipa Radiology $14 98%
Triwest Healthcare Alliance $14 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 - $89 105%
Triwest Health Alliance $15 105%
Wellcare $15 105%
Molina $16 112%
Universal Healthcare Group $17 119%
Verda Health Plan $19 133%
Community Health Choice $21 147%
Superior $21 - $22 147%
Corvel Corporation $28 196%
Omni Healthcare $30 210%
Healthcare Highways $43 301%
Texas Workforce Commission $358 2509%
Evry Health $407 2852%
Imagine Health $522 3658%
Healthsmart Preferred Care $641 - $1,266 4492%
Averde Health $670 4695%
Fidelis Securecare Of Tx $670 4695%
Coventry National First Health $794 5564%
Physicians Cooperative Of Texas $820 5746%
Rockport Workers Comp $820 5746%
Independent Medical System $894 6265%
National Healthcare Solutions $894 6265%
Southwest Medical $894 6265%
Triumph $894 6265%
Coastal Comp $968 6783%
Multiplan $1,118 - $1,266 7835%
Physicians, Inc $1,266 8872%
Affiliated Ppo $1,341 9397%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals