CMS Price Transparency Data

Hepatitis C antibody test

Facility: Baylor Scott & White Medical Center -Taylor

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $101
Cash Discount Price: $142
vs. Medicare Baseline: 7.08x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Baylor Scott & White Medical Center -Taylor is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 7.08x the Medicare baseline. Located in 305 Mallard, Taylor, TX.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $142 (995%)

Insurance Median: $101 (708%)

Cash: $142 (995% of Medicare)

Ins. Median: $101 (708% 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 708% of the Medicare baseline (a markup of 608%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$9	63%
Baylor Scott & White Health Plan	$47 - $101	329%
Triwest	$50	350%
American Health Plan	$52	364%
Blue Cross Blue Shield	$52 - $84	364%
Corvel	$52	364%
Healthspring	$52	364%
Prime Health Services	$52	364%
Procare Advantage	$52	364%
Superior Health Plan	$52	364%
Careworks Fka Rockport	$62	434%
Injury Management Organization	$62	434%
Sedgwick	$62	434%
Cigna	$121 - $142	848%
Aetna	$130	911%
Midcoast	$130	911%
Quiktrip	$130	911%
University Of Mary Hardin-Baylor	$137	960%
Independent Medical System	$142	995%
Curative	$153	1072%
Humana	$153 - $165	1072%
First Health	$165	1156%
Healthsmart	$165 - $177	1156%
Private Health Care System	$177	1240%
Bluebell Creameries	$189	1324%
Three Rivers	$189	1324%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $142.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Baylor Scott & White Medical Center -Taylor is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.