CMS Price Transparency Data

Hepatitis C antibody test

Facility: Yoakum Community Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $34
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 2.38x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Yoakum Community Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.38x the Medicare baseline. Located in 1200 Carl Ramert Drive, Yoakum, TX.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $27 (189%)
Insurance Median: $34 (238%)
Cash: $27 (189% of Medicare)
Ins. Median: $34 (238% 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 238% of the Medicare baseline (a markup of 138%). 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
Blue Cross Blue Shield $17 - $115 119%
Humana $17 119%
Kempton Group Admin Ppo-All Plans $17 119%
Medicare (plans) $17 119%
Prime Health Svcs Mcr Advantage $17 119%
Scott & White Mcare Advan $17 119%
Superior Mcr Advantage $17 119%
Triwest Va Ccn-All Plans $17 119%
Tx Independent Hp Mcr Advantage-All Plans $17 119%
UnitedHealthcare $17 - $34 119%
Superior Hix-All Other Plans $22 154%
Entrust - All Plans $29 203%
Medicaid / KanCare $31 - $42 217%
Amera-Net-All Plans $32 224%
Scott & White Ppo-All Other Plans $32 224%
Healthsmart Ppo-All Other Plans $33 231%
Blue Bell Creameries Emp-All Plans $34 238%
Cigna $34 238%
Americas Health Plan-All Plans $36 252%
Beech Street-All Plans $36 252%
Directcare America-All Plans $36 252%
Galaxy Ppo - All Plans $36 252%
Health Star Comm Ip/Op Only - All Plans $36 252%
Medcorp Southwest Ppo-All Plans $36 252%
Medical Control Ppo-All Plans $36 252%
Phcs Multiplan - All Plans $36 252%
Aetna $38 266%
Healthsmart Work Comp $38 266%
Prime Health Svcs Ppo-All Other Plans $38 266%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Carl Ramert Drive, Yoakum, TX 77995
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals