CMS Price Transparency Data

Hepatitis C antibody test

Facility: Saint Agnes Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $46
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 3.22x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Saint Agnes Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.22x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $44 (308%)
Insurance Median: $46 (322%)
Cash: $44 (308% of Medicare)
Ins. Median: $46 (322% 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 322% of the Medicare baseline (a markup of 222%). 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
Coventry $3 - $119 21%
Healthnet $3 - $141 21%
St Agnes Nicu Valley Childrens Hospital $3 - $112 21%
Allegiance $4 - $133 28%
American Postal Workers Secondary $4 - $133 28%
Cba Network By Design $4 - $130 28%
Cigna $4 - $133 28%
Interplan $4 - $156 28%
Multiplan $4 - $145 28%
Network Health $4 - $130 28%
Phcs $4 - $145 28%
Aetna $14 - $86 98%
Blue Cross Blue Shield $14 - $134 98%
Humana $14 98%
Medicare (plans) $14 - $15 98%
UnitedHealthcare $14 - $29 98%
Welbe Health $15 105%
Align Senior Care $16 112%
Correctcare Integrated Health $18 126%
Medi-Cal Healthnet $20 - $22 140%
Geha $24 168%
Kaiser Permanente $25 175%
Advantek Central Usd $35 245%
Blue Shield - Ca $41 - $134 287%
Meritain $82 575%
Trustmark Small Business Benefits $82 575%
Allied Benefit Systems $86 603%
Boon Chapman $86 603%
Hap $86 603%
Webtpa $86 603%
Blue Benefit Administrators Of Massachusetts $134 939%
Blue Care Network $134 939%
Blue Distinction Transplant $134 939%
Blue Shield - Id (Regence) $134 939%
Blue Shield - Ny Highmark Northeastern $134 939%
Blue Shield - Ny Highmark Western $134 939%
Blue Shield - Pa (Highmark) $134 939%
Blue Shield - Wa (Regence) $134 939%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals