CMS Price Transparency Data
Hepatitis C antibody test
Facility: San Gabriel Valley Medical Center
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $17
- Cash Discount Price: $104
- vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at San Gabriel Valley Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.19x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$104
Average discount available for prompt cash payment at this facility.
Insurance Median
$17
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: $104 (729%)
Insurance Median: $17 (119%)
Cash: $104 (729% of Medicare)
Ins. Median: $17 (119% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Veterans Administration | $10 | 70% |
| Ahmc Medi-Cal Reciprocity | $13 | 91% |
| Allied Physicians | $13 - $21 | 91% |
| Altamed Health Network | $13 - $14 | 91% |
| Beverly Hospital | $13 - $16 | 91% |
| Brand New Day | $13 - $121 | 91% |
| Emanate Health | $13 - $18 | 91% |
| Healthnet Medi-Cal Non-Contract | $13 | 91% |
| Healthy Way La | $13 | 91% |
| Non Contracting Medi Cal | $13 | 91% |
| Aetna | $14 - $25 | 98% |
| Aids Healthcare Foundation | $14 - $138 | 98% |
| Alignment Health Plan | $14 | 98% |
| Apa/Aco Inc | $14 | 98% |
| Avanti | $14 - $17 | 98% |
| Blue Cross Blue Shield | $14 - $69 | 98% |
| Blue Shield Of California | $14 - $201 | 98% |
| Central Health Plan | $14 - $208 | 98% |
| Cv-19 Hrsa Uninsured Testing And Tx | $14 | 98% |
| Health Net | $14 - $201 | 98% |
| Health Net Inc | $14 - $33 | 98% |
| Hollywood Presbyterian Adv Med Mcal | $14 | 98% |
| Hollywood Presbyterian Medpoint Mcal | $14 | 98% |
| Humana | $14 | 98% |
| Inter Valley Health Plan | $14 | 98% |
| La Care Health Plan | $14 | 98% |
| Medicaid / KanCare | $14 | 98% |
| Medicare (plans) | $14 | 98% |
| Molina Healthcare Of California | $14 - $135 | 98% |
| Pacific Alliance Medical Center | $14 | 98% |
| Pacificare Of California | $14 - $113 | 98% |
| Physicians Healthways | $14 | 98% |
| Providence Health Network | $14 | 98% |
| Self-Pay | $14 | 98% |
| St Vincent Medical Center/Psych | $14 | 98% |
| Tricare | $14 | 98% |
| Wellcare | $14 | 98% |
| Athens Administrators | $17 | 119% |
| Beech Street | $17 - $277 | 119% |
| Chinatown Service Center Pace | $17 | 119% |
| Cigna | $17 | 119% |
| Other Non Contracting Workers Comp | $17 | 119% |
| Ahmc Health Self-Insurance Epo | $18 | 126% |
| Care 1St Health Plan | $18 - $225 | 126% |
| Knox-Keene Act | $18 | 126% |
| UnitedHealthcare | $29 - $57 | 203% |
| Private Pay | $40 | 280% |
| Ahmc Reciprocity | $104 | 729% |
| Alignment Healthplan | $121 | 848% |
| Clever Care | $121 | 848% |
| Pacific Independent Physician Associates | $138 | 967% |
| Facey Medical | $173 | 1212% |
| Community Care Network | $225 | 1577% |
| Choicecare Network | $242 | 1696% |
| Private Healthcare Systems (Phcs) | $242 | 1696% |
| Affiliated Health Fund | $260 | 1822% |
| Multiplan | $311 | 2179% |
| Ppo Next | $311 | 2179% |
| Managed Health Network | $346 | 2425% |
| Medi-Cal Sub Acute | $346 | 2425% |
| One Legacy | $346 | 2425% |
| Other Non Contracted Commercial | $346 | 2425% |
| Us Behavioral Health Plan | $346 | 2425% |