CMS Price Transparency Data

Hepatitis C antibody test

Facility: Medical City Plano

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $21
  • Cash Discount Price: $982
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Medical City Plano is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $982. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.47x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$982

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $982 (6882%)
Insurance Median: $21 (147%)
Cash: $982 (6882% of Medicare)
Ins. Median: $21 (147% 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%
United $12 - $171 84%
Aetna $13 - $594 91%
Cigna $13 - $137 91%
Molina $13 - $16 91%
Parkland Community Health Plan $13 91%
Blue Cross Blue Shield $14 - $436 98%
Care N Care $14 98%
Devoted Health $14 98%
Humana $14 - $158 98%
Mutual Of Omaha $14 98%
Triwest Veterans $14 98%
Wellmed $14 98%
American Health Plan Of Texas, Inc. $15 105%
Integranet $15 105%
Procare Advantge $15 105%
Provider Partners Health Plan $15 105%
Superior Health Plan $15 - $69 105%
Texas Independent Health Plan $15 105%
Triwest Health Alliance $15 105%
Wellcare $15 105%
Imperial Insurance Company $16 112%
Universal Healthcare Group $17 119%
Verda Health Plan $19 133%
Bravo Health $21 147%
Superior $26 - $32 182%
Usa Managed Care $27 - $786 189%
Corvel Corporation $28 196%
Molina Healthcare $37 259%
Oscar $37 259%
Healthcare Highways $241 - $332 1689%
Evry Health $253 1773%
Lifecare Hospitals $295 2067%
Prominence Health Plan $393 2754%
City Of Mckinney $442 3097%
Fidelis Securecare $442 3097%
National Choicecare $491 3441%
Pc Texas Partners $540 3784%
Physicians Coop Of Tx $540 3784%
Rockport Health Group $540 3784%
Averde Health, Inc $570 3994%
Texas Healthcare Foundation Wc $638 4471%
Coastal Comp Health Networks $687 4814%
Mega Life $687 4814%
Multiplan Phcs $687 4814%
Healthsmart Preferred Care $737 5165%
Lewisville Isd/Dls Consulting $737 5165%
Usc Health Services $786 5508%
Galaxy Health Network $835 5851%
Independent Medical Systems $982 6882%
National Healthcare Solutions $982 6882%
Unicare $982 6882%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals