CMS Price Transparency Data

Hepatitis C antibody test

Facility: Lewisgale Hospital Pulaski

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $88
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 6.17x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Lewisgale Hospital Pulaski is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.17x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$88

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: $573 (4015%)
Insurance Median: $88 (617%)
Cash: $573 (4015% of Medicare)
Ins. Median: $88 (617% 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 617% of the Medicare baseline (a markup of 517%). 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
Humana $11 - $14 77%
Triatlantic $12 84%
Health Net $13 91%
Aetna $14 - $258 98%
Devoted $14 98%
Good Samaritan Hospice $14 98%
Magellan $14 98%
Sentara Health $14 98%
United $14 - $258 98%
United Mine Workers $14 98%
Align Senior Care $15 105%
Blue Cross Blue Shield $15 - $68 105%
Cigna $15 105%
Clear Spring Health Plan $15 105%
Evernorth Behavioral Health $15 105%
Pyramid Life $15 105%
Virginia Premier Health $15 105%
Lifeworks $109 764%
Universal Healthcare Group $126 883%
Virginia Health Network $201 - $407 1409%
Greenvbrier Sporting Club $344 2411%
Corvel $413 2894%
Richfield Nursing Center $430 3013%
Richfield Retirement Community $430 3013%
Multiplan $441 3090%
Community Care Network $458 3210%
Graham-White Manufacturing $458 3210%
Occunet Workers Comp $458 3210%
One Health Plan $458 3210%
Patients Choice $504 3532%
4Most $516 3616%
American Postal Workers Union $516 3616%
Phcs $516 3616%
Star Transportation $516 3616%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Lee Highway, Pulaski, VA 24301
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals