CMS Price Transparency Data

Hepatitis C antibody test

Facility: Memorial Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $60
  • Cash Discount Price: $71
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Memorial Medical Center is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.20x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$71

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $71 (498%)
Insurance Median: $60 (420%)
Cash: $71 (498% of Medicare)
Ins. Median: $60 (420% 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 420% of the Medicare baseline (a markup of 320%). 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 Mcr Adv-All Other Plans $21 - $36 147%
Care Improvement Plus - All Other Plans $21 - $36 147%
Care Improvement Plus Mcr $21 - $36 147%
Coventry First Hlth Mcr Adv $21 - $36 147%
Multiplan Mcr Adv $21 - $36 147%
Superior Allwell Mcr Adv-All Other Plans $21 - $36 147%
Triwest Va Pccc-All Plans $21 - $35 147%
UnitedHealthcare $21 - $102 147%
Universal American Mcr-All Other Plans $21 - $36 147%
Universal American Snp $22 - $37 154%
Ambetter / Centene $25 - $43 175%
Amerigroup Chip $36 - $61 252%
Amerigroup Star $36 - $61 252%
Amerigroup Star Kids $36 - $61 252%
Amerigroup Star Plus $36 - $61 252%
Comm Health Chip $36 - $61 252%
Comm Health Perinatal-All Other Plans $36 - $61 252%
Molina Chip/Star-All Plans $36 - $61 252%
Scott & White Chip/Star-All Plans $36 - $61 252%
Superior Chip/Star $36 - $61 252%
Texas Childrens Hp - All Plans $36 - $61 252%
Comm Health Mcaid Hmo $38 - $64 266%
Comm Health Star $38 - $64 266%
Prime Healthcare Services-All Plans $52 - $89 364%
Cigna $56 - $95 392%
Aetna $60 - $102 420%
Capstar Health Network-All Plans $60 - $102 420%
Coventry First Hlth Hmo Ppo-All Other Plans $60 - $102 420%
Healthcare Highways-All Plans $60 - $102 420%
Humana $60 - $102 420%
Corvel Work Comp-All Plans $64 - $108 448%
Galaxy Health Network-All Plans $64 - $108 448%
Independent Med Sys Ppo-All Plans $64 - $108 448%
Multiplan Phcs Ppo-All Other Plans $64 - $108 448%
Provider Select Ppo-All Plans $64 - $108 448%
Three Rivers Ppo-All Plans $64 - $108 448%
Usa Mso - All Plans $64 - $108 448%
Blue Cross Blue Shield $70 - $73 491%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals