CMS Price Transparency Data

Hepatitis C antibody test

Facility: Texas Health Presbyterian Hospital Allen

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $54
  • Cash Discount Price: $192
  • vs. Medicare Baseline: 3.78x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Texas Health Presbyterian Hospital Allen is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.78x the Medicare baseline. Located in 1105 Central Expressway North, Allen, TX.
Cash / Self-Pay
$192

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $192 (1345%)
Insurance Median: $54 (378%)
Cash: $192 (1345% of Medicare)
Ins. Median: $54 (378% 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 378% of the Medicare baseline (a markup of 278%). 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
Amerigroup $12 - $15 84%
Blue Cross Blue Shield $12 - $84 84%
Parkland $12 84%
UnitedHealthcare $12 - $16 84%
Molina $13 - $15 91%
Superior Wellcare $13 - $16 91%
American Health $14 98%
Healthspring $15 105%
Humana $15 105%
Fort Worth Firefighters $28 - $196 196%
Aetna $48 - $225 336%
Cigna $59 - $302 413%
City Of Fort Worth $151 1058%
Quick Trip $228 1598%
Healthsmart $241 - $269 1689%
Phcs $268 1878%
Multiplan $279 1955%
Galaxy $282 1976%
Usa $282 1976%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1105 Central Expressway North, Allen, TX 75013
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals