CMS Price Transparency Data

Hepatitis C antibody test

Facility: Sheridan Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $24
Cash Discount Price: $45
vs. Medicare Baseline: 1.68x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Sheridan Memorial Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.68x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $45 (315%)

Insurance Median: $24 (168%)

Cash: $45 (315% of Medicare)

Ins. Median: $24 (168% 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
Pacificsource-All Plans	$4 - $12	28%
Humana	$14	98%
Blue Cross Blue Shield	$21 - $72	147%
UnitedHealthcare	$21 - $75	147%
Wy School Boards-All Plans	$21 - $73	147%
C1 Employee - All Plans	$22 - $78	154%
Casper Opco Llc - All Plans	$22 - $78	154%
First Health Comm - All Plans	$22 - $78	154%
Miscellaneous-All Plans	$22 - $78	154%
Cigna	$23 - $81	161%
Wise Provider Network-All Plans	$23 - $81	161%
Ebms - All Plans	$24 - $83	168%
First Choice Comm - All Plans	$24 - $83	168%
Phcs Multiplan-All Plans	$24 - $83	168%
Three Rivers-All Plans	$24 - $83	168%

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 $45.
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 Sheridan 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.