CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Houston Healthcare Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $15
  • Cash Discount Price: $1,534
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Houston Healthcare Medical Center is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,534. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
$1,534

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: $1,534 (10750%)
Insurance Median: $15 (105%)
Cash: $1,534 (10750% 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.

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
Superior Health Plan $3 - $120 21%
United $10 - $903 70%
Community Health Choice Mcd $12 84%
Aetna $13 - $94 91%
Molina Healthcare $13 - $31 91%
Blue Cross Blue Shield $14 - $703 98%
Cigna $14 - $75 98%
Devoted Health $14 98%
Humana $14 - $191 98%
Oscar $14 - $41 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%
Triwest Health Alliance $15 105%
Wellcare $15 105%
Evry Health $16 - $548 112%
Molina $16 112%
Verda Health Plan $19 133%
Community Health Choice $21 147%
Superior $21 - $22 147%
Coventry National First Health $31 - $1,070 217%
Healthcare Highways $43 301%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals