CMS Price Transparency Data

Hepatitis C antibody test

Facility: Medina Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $49
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Medina Regional Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.43x the Medicare baseline. Located in 3100 Avenue E, Hondo, TX.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $95 (666%)
Insurance Median: $49 (343%)
Cash: $95 (666% of Medicare)
Ins. Median: $49 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
UnitedHealthcare $16 - $108 112%
Superior Health Plan $17 - $56 119%
Community First Health Plan $20 - $144 140%
Amerivantage $22 - $48 154%
Curative $23 - $86 161%
Aetna $24 - $86 168%
Cigna $27 - $58 189%
Blue Advantage $34 - $72 238%
Blue Cross Blue Shield $65 456%
Benefit Administrators $68 - $144 477%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Avenue E, Hondo, TX 78861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals