CMS Price Transparency Data

Hepatitis C antibody test

Facility: Valley Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $28
  • Cash Discount Price: $1,017
  • vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Valley Regional Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,017. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.96x the Medicare baseline. Located in 100 A Alton Gloor, Brownsville, TX.
Cash / Self-Pay
$1,017

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $1,017 (7127%)
Insurance Median: $28 (196%)
Cash: $1,017 (7127% of Medicare)
Ins. Median: $28 (196% 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
Driscoll Childrens Health Plan $12 84%
Texas Health Network $12 84%
United $12 - $457 84%
Usa Mco $12 84%
Aetna $13 - $151 91%
Molina Healthcare $13 - $30 91%
Blue Cross Blue Shield $14 - $457 98%
Cigna $14 - $52 98%
Humana $14 - $183 98%
Independent Medical System $14 98%
Triwest Healthcare Alliance $14 98%
Wellmed $14 98%
American Health Plan $15 105%
Physicians Health Choice $15 105%
Prominence Health $15 105%
Provider Partners Health Plan Of Texas $15 105%
Shared Health $15 105%
Superior Health Plan $15 - $71 105%
Molina $16 112%
Superior $22 154%
Corvel Corporation $28 196%
Omni Healthcare $30 210%
Oscar $34 238%
Healthcare Highways $43 301%
Texas Workforce Commission $244 1710%
Averde Health $335 2348%
Healthsmart Preferred Care $437 - $864 3062%
First Health $585 4100%
National Healthcare Solutions $610 4275%
Southwest Medical $610 4275%
Coastal Comp $661 4632%
Total E&P Mexico $661 4632%
Affiliated Healthcare $691 4842%
Mcm Maxcare $813 5697%
Pronet Ppo $813 5697%
Usa Managed Care $813 5697%
Beech Street $915 6412%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 A Alton Gloor, Brownsville, TX 78526
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals