CMS Price Transparency Data

Hepatitis C antibody test

Facility: PAM Rehabilitation Hospital of Allen

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $168
  • Cash Discount Price: $224
  • vs. Medicare Baseline: 11.77x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at PAM Rehabilitation Hospital of Allen is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 11.77x the Medicare baseline. Located in 1001 Raintree Circle, Allen, TX.
Cash / Self-Pay
$224

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $224 (1570%)
Insurance Median: $168 (1177%)
Cash: $224 (1570% of Medicare)
Ins. Median: $168 (1177% 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 1177% of the Medicare baseline (a markup of 1077%). 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
Superior Health $12 84%
America'S Choice Provider Network $157 1100%
Provider Network Of America $168 1177%
Quik Trip $168 1177%
Usa Managed Care Organization $168 1177%
Velocity Provider Ppo Network $168 1177%
Multiplan/Phcs $179 1254%
Prime Health Services $191 1338%
Medincrease $202 1416%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1001 Raintree Circle, Allen, TX 75013
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL