CMS Price Transparency Data

Hepatitis C antibody test

Facility: Kell West Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $48
  • Cash Discount Price: $160
  • vs. Medicare Baseline: 3.36x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Kell West Regional Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.36x the Medicare baseline. Located in 5420 Kell West Boulevard, Wichita Falls, TX.
Cash / Self-Pay
$160

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $160 (1121%)
Insurance Median: $48 (336%)
Cash: $160 (1121% of Medicare)
Ins. Median: $48 (336% 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 336% of the Medicare baseline (a markup of 236%). 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
Aetna $12 - $14 84%
Medicaid / KanCare $12 84%
Uhc_Community_Plan $12 84%
Blue Cross Blue Shield $14 - $50 98%
Humana $14 - $226 98%
Medadv_Uhc $14 98%
Medicare (plans) $14 98%
UnitedHealthcare $18 126%
Cigna $21 - $158 147%
Healthsmart_Ppo $42 - $158 294%
Blue_Advantage_Bav $43 301%
Blue_Essentials $45 315%
Phcs $45 - $169 315%
Self_Pay $48 - $180 336%
Multiplan $51 - $192 357%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5420 Kell West Boulevard, Wichita Falls, TX 76310
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals