CMS Price Transparency Data

Hepatitis C antibody test

Facility: Methodist McKinney Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $15
Cash Discount Price: $13
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Methodist McKinney Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 8000 W Eldorado Pkwy Bldg C Suite C, McKinney, TX.

Cash / Self-Pay

$13

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $13 (91%)

Insurance Median: $15 (105%)

Cash: $13 (91% of Medicare)

Ins. Median: $15 (105% 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.

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
Blue Cross Blue Shield	$9 - $15	63%
Aetna	$14 - $52	98%
Medicare (plans)	$14 - $15	98%
UnitedHealthcare	$14 - $15	98%
Ust Health Proof [1005]	$14	98%
Wellcare [7016]	$14	98%
American Health Advantage Of Texas [7099]	$15	105%
Cigna	$15	105%
Globalhealth [1003]	$15	105%
Humana	$15	105%
Procare Advantage [7018]	$15	105%
Provider Partners Health Plan [7025]	$15	105%
Southwestern Health Resources Swhr [7015]	$15	105%
Alternative Service Concepts [8005]	$18	126%
Oscar Insurance Company [2057]	$19	133%
Bright Healthcare [2222]	$20	140%
Molina [3017]	$21	147%
Wellpoint Marketplace Exchange [3071]	$22	154%
90 Degree Benefit [3057]	$24	168%
Allied National [2031]	$24	168%
Ambetter / Centene	$24	168%
Entrust/90 Degree [2058]	$24	168%
Friday Health Plan [2061]	$24	168%
Imperial Insurance Companies [3073]	$26	182%
Evry Health [1013]	$29	203%
Sana Benefits [3069]	$29	203%
Velocity [3070]	$29	203%
Web Tpa [3049]	$47 - $52	329%

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 $13.
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 Methodist McKinney Hospital 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.