CMS Price Transparency Data

Hepatitis C antibody test

Facility: Preston Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $21
Cash Discount Price: $13
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Preston Memorial Hospital is $21. 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 1.47x the Medicare baseline. Located in 150 Memorial Drive, Kingwood, WV.

Cash / Self-Pay

$13

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $21 (147%)

Cash: $13 (91% of Medicare)

Ins. Median: $21 (147% 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
Advantra	$3 - $39	21%
Aetna	$3 - $58	21%
Humana	$3 - $39	21%
Medicaid / KanCare	$3 - $44	21%
Medicare (plans)	$3 - $53	21%
Uhc_Va	$3 - $39	21%
Upmc	$3 - $41	21%
Blue_Cross_Highmark_Aca	$4 - $47	28%
Blue_Cross_Highmark_Pos	$4 - $52	28%
Blue_Cross_Highmark_Ppo	$4 - $52	28%
Blue_Cross_Highmark_Traditional	$4 - $58	28%
UnitedHealthcare	$4 - $58	28%
4_Most	$5 - $63	35%
Cigna	$5 - $60	35%
Geha	$5 - $62	35%
Health	$5 - $63	35%
Unicare	$103	722%

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 Preston Memorial 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.