CMS Price Transparency Data

Hepatitis C antibody test

Facility: San Antonio Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $44
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 3.08x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at San Antonio Regional Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.08x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $185 (1296%)
Insurance Median: $44 (308%)
Cash: $185 (1296% of Medicare)
Ins. Median: $44 (308% 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 308% of the Medicare baseline (a markup of 208%). 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
Healthnet Medi-Cal $11 77%
Blue Shield Mcr Adv $14 98%
Caremore Mcr Adv - All Plans $14 98%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $14 98%
Healthnet Mcr Adv $14 98%
Humana $14 98%
Iehp Mcr Adv $14 98%
Inter Valley Hp Mcr Adv- All Plans $14 98%
Kindred Mcr Adv-All Plans $14 98%
Molina Mcr Adv $14 98%
Scan Health Plan Mcr Adv-All Plans $14 98%
Tricare $14 98%
Universal Care - All Plans $14 98%
Blue Cross Blue Shield $15 - $167 105%
Kasiser Mcr Adv $15 105%
Zelis Mcr Adv $15 105%
Imperial Health Mcr Adv-All Plans $16 112%
Medi-Cal $16 112%
Kaiser Medi-Cal $17 119%
Alpha Care Mg Mcal/Hlthy Kids $18 126%
Choice Phycn Ntwrk Op Only $18 126%
Heritage Prov Ntwrk/Regal Mcal $18 126%
Aetna $19 - $307 133%
Molina Exchange-All Other Plans $19 133%
Molina Medi-Cal $19 133%
Iehp Comm - All Other Plans $21 147%
Iehp Mcal $21 147%
Redlands Employee $21 147%
Redlands Hmo-All Other Plans $22 154%
Prime Health - All Plans $25 175%
Healthnet - All Other Plans $34 238%
Blue Shield Epn $40 280%
Kaiser Comm - All Other Plans $40 280%
UnitedHealthcare $44 - $201 308%
Cigna $52 364%
Ambetter / Centene $56 392%
Epic Health Plan - All Other Plans $92 645%
Blue Shield Hmo Pos / Calpers Ppo $114 799%
Blue Shield Epo Ppo - All Other Plans $123 862%
Pc Inland Valley Scan $154 1079%
Pc Inland Valley-All Other Plans $154 1079%
Coventry Ccn/First Hlth - All Plans $169 1184%
Choicecare Ntwrk-All Plans $221 1549%
Multiplan/Phcs - All Plans $221 1549%
Networks By Design - All Plans $230 1612%
Zelis Comm-All Other Plans $230 1612%
Foundation Inland Epo-All Other Plans $246 1724%
Foundation Inland Ppo $261 1829%
Health Payors - All Plans $276 1934%
Interplan - All Plans $276 1934%
Wellcare/Easy Choice-All Plans $301 2109%
Alpha Care Mg Mcr Adv $307 2151%
Central Hlth Plan Mcr Adv-All Plans $307 2151%
Epic Health Plan Mcr Adv $307 2151%
Prospect Hp-All Plans $307 2151%
Providence Clevercare Mcr Adv $307 2151%
Heritage Prov Ntwrk/Regal Mcr Adv $312 2186%
Clever Care Mcr Adv - All Plans $322 2256%
La Salle Hp Mcr Adv-All Plans $322 2256%
Providence Oscar-All Other Plans $322 2256%
Alpha Care Mg-All Other Plans $384 2691%
Heritage Prov Ntwrk/Regal - All Other Plans $564 3952%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals