CMS Price Transparency Data

Hepatitis C antibody test

Facility: St David's South Austin Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $34
  • Cash Discount Price: $742
  • vs. Medicare Baseline: 2.38x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St David's South Austin Medical Center is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $742. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.38x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$742

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $742 (5200%)
Insurance Median: $34 (238%)
Cash: $742 (5200% of Medicare)
Ins. Median: $34 (238% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 238% of the Medicare baseline (a markup of 138%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
St David’S Hospice $12 - $14 84%
United $12 - $334 84%
Blue Cross Blue Shield $13 - $237 91%
Molina Healthcare $13 - $16 91%
Aetna $14 - $15 98%
Cigna $14 - $215 98%
Devoted Health $14 98%
Harbor Hospice $14 98%
Humana $14 - $15 98%
Odyssey Hospice $14 98%
Triwest Veterans $14 98%
Wellmed $14 98%
American Health Plan Of Texas $15 105%
Provider Partners Health Plan $15 105%
Pyramid Life $15 105%
Sendero $15 - $24 105%
Shared Health $15 105%
Superior Health Plan $15 - $126 105%
Texas Independent Health Plan $15 105%
Wellcare $15 105%
Imperial Insurance $16 112%
Triwest Health Alliance $16 112%
Universal Health $17 119%
Austin Fc $18 126%
Amerigroup $20 140%
Naphcare $22 154%
Seven Corners $22 154%
Corvel Corporation $28 196%
UnitedHealthcare $36 - $742 252%
Oscar $39 - $44 273%
Moda $174 1219%
Covenant Management Systems $214 1500%
Healthcare Highways $216 - $223 1514%
Imo Med - Select Network $223 1563%
Nomi Health $237 - $275 1661%
Moda Health $267 - $275 1871%
Evry Health $273 1913%
Texas Healthcare Foundation Heb $275 1927%
Texas Workforce Commission $289 2025%
Harbor Health Team $297 2081%
Averde Health $334 2341%
Comanche County $371 2600%
Emerging Therapy Solutions $371 - $512 2600%
National Choicecare $371 2600%
Healthsmart Preferred Care $408 - $594 2859%
Independent Medical Systems $408 2859%
Physicians Cooperative Of Texas $408 2859%
Prime Health $445 3118%
First Health $467 - $534 3273%
Coastal Comp Health Networks $482 3378%
National Health Care $482 3378%
Occunet $519 3637%
Texas Municipal League $519 3637%
Medcorp Southwest $556 3896%
Preferred Health Arrangement $556 3896%
Rockport Healthcare Group $594 - $668 4163%
Bce Emergis Corporation $668 4681%
Beech Street $668 4681%
Medical Control Network Solutions $668 4681%
Multiplan $668 4681%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals