CMS Price Transparency Data

Hepatitis C antibody test

Facility: Harlingen Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $18
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Harlingen Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.26x the Medicare baseline. Located in 5501 South Expressway 77, Harlingen, TX.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $14 (98%)
Insurance Median: $18 (126%)
Cash: $14 (98% of Medicare)
Ins. Median: $18 (126% 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
Medicaid / KanCare $12 - $25 84%
Superior Health Plan $12 - $24 84%
Molina $13 - $26 91%
Aetna $14 98%
Blue Cross Blue Shield $14 - $45 98%
Careworks Worker Compensation Fka Rockport Community Network $14 98%
Cigna $14 - $23 98%
Humana $14 98%
Medicare (plans) $14 98%
San Benito Medical Associates $14 98%
Texas Bluebonnett Health Plan $14 - $24 98%
Tricare $14 98%
UnitedHealthcare $14 - $18 98%
Veterans Evaluation Services $14 98%
Wellmed $14 98%
Workers Compensation $14 98%
Imperial Insurance Company $15 105%
Provider Partners Health Plan $15 105%
Asserta Health $19 133%
Friday Health Plan $19 133%
Magic Valley Electric Cooperative $19 133%
Superior Health Commercial Exchange $19 133%
Employer Direct Healthcare $20 140%
Corporate Remedies Worker Compensation $21 147%
Naphcare $22 154%
Baker Benefits Administrators $29 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5501 South Expressway 77, Harlingen, TX 78550
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals