CMS Price Transparency Data

Hepatitis C antibody test

Facility: Seton Medical Center Harker Heights

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $178
Cash Discount Price: $46
vs. Medicare Baseline: 12.47x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Seton Medical Center Harker Heights is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 12.47x the Medicare baseline. Located in 850 W Central Texas Expressway, Harker Heights, TX.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $46 (322%)

Insurance Median: $178 (1247%)

Cash: $46 (322% of Medicare)

Ins. Median: $178 (1247% 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 1247% of the Medicare baseline (a markup of 1147%). 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
Healthscope Benefits [2290]	$82	575%
UnitedHealthcare	$82 - $178	575%
Aetna	$84 - $262	589%
Healthcare Highways [2210]	$178	1247%
Medicaid / KanCare	$178 - $489	1247%
Oncology Patient Assistance Programs [2295]	$178	1247%
Selecthealth [3740]	$178	1247%
Web Tpa [2115]	$178 - $365	1247%
Oscar Exchange [6080]	$199	1395%
Humana	$299	2095%
Blue Cross Blue Shield	$338	2369%
First Care Commercial [1371]	$342	2397%
Allied Benefit Systems Inc [1030]	$365	2558%
Cigna	$395	2768%

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 $46.
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 Seton Medical Center Harker Heights 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.