CMS Price Transparency Data

Hepatitis C antibody test

Facility: Seymour Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $86
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 6.03x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Seymour Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.03x the Medicare baseline. Located in 200 Stadium Drive, Seymour, TX.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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: $122 (855%)
Insurance Median: $86 (603%)
Cash: $122 (855% of Medicare)
Ins. Median: $86 (603% 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 603% of the Medicare baseline (a markup of 503%). 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
Geha $13 91%
United Hmo/Ppo $13 91%
Aetna $14 - $242 98%
Triwest $14 98%
Medicaid / KanCare $20 140%
Superior Health $20 140%
Humana $70 - $157 491%
Medicare (plans) $70 - $157 491%
Wellmed $70 - $157 491%
Blue Cross Blue Shield $86 - $194 603%
Cigna $86 - $194 603%
Galaxy Health Network $86 - $194 603%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Stadium Drive, Seymour, TX 76380
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals