CMS Price Transparency Data

Hepatitis C antibody test

Facility: Round Rock Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $33
  • Cash Discount Price: $2,191
  • vs. Medicare Baseline: 2.31x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Round Rock Medical Center is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,191. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.31x the Medicare baseline. Located in 2400 Round Rock Ave, Round Rock, TX.
Cash / Self-Pay
$2,191

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $2,191 (15354%)
Insurance Median: $33 (231%)
Cash: $2,191 (15354% of Medicare)
Ins. Median: $33 (231% 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 231% of the Medicare baseline (a markup of 131%). 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.

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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 - $986 84%
Blue Cross Blue Shield $13 - $699 91%
Molina Healthcare $13 - $16 91%
Aetna $14 - $15 98%
Cigna $14 - $40 98%
Devoted Health $14 98%
Humana $14 - $15 98%
Odyssey Hospice $14 98%
Triwest Healthcare Alliance $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 - $372 105%
Texas Independent Health Plan $15 105%
Triwest Health Alliance $15 105%
Wellcare $15 105%
Imperial Insurance $16 112%
Universal Health $17 119%
Austin Fc $18 126%
Amerigroup $20 140%
Naphcare $22 154%
Corvel Corporation $28 196%
Oscar $39 - $44 273%
Moda $515 3609%
Covenant Management Systems $631 4422%
Healthcare Highways $638 - $657 4471%
Imo Med - Select Network $657 4604%
Nomi Health $701 - $811 4912%
Moda Health $789 - $811 5529%
Evry Health $806 5648%
Texas Healthcare Foundation Heb $811 5683%
Texas Workforce Commission $854 5985%
Harbor Health Team $876 6139%
Averde Health $986 6910%
Comanche County $1,096 7680%
National Choicecare $1,096 7680%
Healthsmart Preferred Care $1,205 - $1,753 8444%
Independent Medical Systems $1,205 8444%
Physicians Cooperative Of Texas $1,205 8444%
Prime Health $1,315 9215%
First Health $1,380 - $1,575 9671%
Coastal Comp Health Networks $1,424 9979%
National Health Care $1,424 9979%
Occunet $1,534 10750%
Texas Municipal League $1,534 10750%
Medcorp Southwest $1,643 11514%
Preferred Health Arrangement $1,643 11514%
Rockport Healthcare Group $1,753 - $1,972 12285%
Bce Emergis Corporation $1,972 13819%
Beech Street $1,972 13819%
Medical Control Network Solutions $1,972 13819%
Multiplan $1,972 13819%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Round Rock Ave, Round Rock, TX 78681
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals