CMS Price Transparency Data

Hepatitis C antibody test

Facility: Yoakum County Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $100
  • Cash Discount Price: $138
  • vs. Medicare Baseline: 7.01x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Yoakum County Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 7.01x the Medicare baseline. Located in 412 Mustang Avenue, Denver City, TX.
Cash / Self-Pay
$138

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $138 (967%)
Insurance Median: $100 (701%)
Cash: $138 (967% of Medicare)
Ins. Median: $100 (701% 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 701% of the Medicare baseline (a markup of 601%). 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
Firstcare $14 - $97 98%
Multiplan $14 - $121 98%
90 Degree Benefits $69 484%
Cigna $90 631%
Humana $90 631%
Insurance Services Of Lubbock $90 631%
UnitedHealthcare $90 - $111 631%
Aetna $92 - $118 645%
Dars $97 680%
Blue Cross Blue Shield $100 - $138 701%
Healthsmart $117 820%
Phcs $118 827%
Capstar $124 869%
Provider Network $135 946%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 412 Mustang Avenue, Denver City, TX 79323
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals