CMS Price Transparency Data

Hepatitis C antibody test

Facility: Freestone Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $25
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Freestone Medical Center is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.75x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $85 (596%)
Insurance Median: $25 (175%)
Cash: $85 (596% of Medicare)
Ins. Median: $25 (175% 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 $8 - $36 56%
Gilsbar $9 - $121 63%
Aarp $12 84%
Apwu $12 84%
Fringe Benefits $12 84%
Geha $12 84%
Mcaid $12 - $25 84%
Misc Mcaid Hmo $12 - $36 84%
Superior Health Chip $12 - $25 84%
Tx Childrens Mcaid $12 - $25 84%
Uhcss $12 84%
UnitedHealthcare $12 - $36 84%
Aarp Mcare /Wellmed $14 98%
Aetna $14 - $97 98%
Allwell Superior Hlth $14 98%
Ambetter / Centene $14 98%
Care Improvement Plus $14 98%
Champva $14 98%
Humana $14 - $121 98%
Medicaid / KanCare $14 - $56 98%
Medicare (plans) $14 98%
Misc Mcare Replacement $14 98%
Pphp Prov Part Hlth Plan $14 98%
Rightcare S&W Mcaid $14 - $36 98%
Scott & White Senior Care $14 98%
Superior Health Mcd $14 - $56 98%
Superior Hlth Mcare Repl $14 98%
Tricare $14 98%
Triwest $14 98%
Triwest Va Ccn Claims $14 98%
Utmb Corr Mgd Care $14 98%
Va Vha Office Comm Care $14 98%
Veteran'S Administration $14 98%
Wellmed $14 98%
Blue Cross Blue Shield $16 - $109 112%
Scott & White Commercial $17 119%
Scott & White Employees $17 119%
Workers Compensation $29 203%
Cigna $73 512%
Misc Multiplan $85 596%
Misc Multiplan Auto $85 596%
Misc Multiplan Workcomp $85 596%
Self Pay Gt 083123 $85 596%
Self Pay Lt 090123 $85 596%
Aflac $121 848%
Bankers Life $121 848%
Fairview Nursing Home $121 848%
Icare $121 848%
Inmate Freestone Co $121 848%
Misc Hospice $121 848%
Miscellaneous $121 848%
Miscellaneous Auto $121 848%
Mutual Of Omaha $121 848%
North American Med Empl $121 848%
Standard Life Insurance $121 848%
Tml $121 848%
Zelis Healthcare $121 848%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals