CMS Price Transparency Data

Hepatitis C antibody test

Facility: Grandview Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $55
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 3.85x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Grandview Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.85x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $36 (252%)
Insurance Median: $55 (385%)
Cash: $36 (252% of Medicare)
Ins. Median: $55 (385% 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 385% of the Medicare baseline (a markup of 285%). 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
Medicaid / KanCare $10 70%
Bc Pml $11 77%
Node Champva $12 84%
Tricare $12 84%
UnitedHealthcare $13 - $82 91%
Aetna $14 - $16 98%
Blue Advantage $14 98%
Cigna $14 - $27 98%
Hospice $14 98%
Humana $14 98%
Medicare (plans) $14 98%
Node Clover Health Mcr Adv $14 98%
Node Devoted Health Mcr Adv $14 98%
Node Va $14 98%
Select Health $14 98%
Veterans Eval Services $14 98%
Victory Health $14 98%
Viva Health $14 - $101 98%
Node Wellcare Mcr Adv $15 105%
Blue Cross Blue Shield $18 126%
Node Us Dept Of Labor $18 126%
Ambetter / Centene $21 147%
Healthspring $25 175%
Self Pay $27 - $44 189%
Bp Health Advocate $46 322%
Ag Administrators $64 448%
Alamed $64 448%
Choicecare $64 448%
Drummond $64 448%
American Employee Alliance $73 512%
Healthchoice $92 - $110 645%
Value Options $92 645%
First Health $110 - $143 771%
Multiplan $112 - $128 785%
Blue Bell Creameries $128 897%
Natl Comp Care $137 960%
Usa Ppo $137 960%
Coventry Work Comp Al $143 1002%
Novanet $148 1037%
Alabama Wc $156 1093%
Cal-Med $156 1093%
Corvel $156 1093%
Associated Admin $165 1156%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals