CMS Price Transparency Data

Hepatitis C antibody test

Facility: Ventura County Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $29
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 2.03x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Ventura County Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.03x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $46 (322%)
Insurance Median: $29 (203%)
Cash: $46 (322% of Medicare)
Ins. Median: $29 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Tricare $4 - $18 28%
Vchcp-All Plans $5 - $23 35%
Blue Shield Epn $10 - $48 70%
Aetna $14 - $123 98%
Alignment Hp - All Plans $14 98%
Blue Shield Mcr Adv $14 98%
Healthnet Comm-All Other Plans $14 - $68 98%
Humana $14 98%
Kaiser Comm Pediatric Ip/Op Only $14 - $68 98%
UnitedHealthcare $14 - $67 98%
Healthnet Mcr Adv $15 105%
Americas Hp Mcr Adv Ip/Op Only $16 112%
Clinicas Mcr Adv $16 112%
Hpn Ip/Op Only Medi-Cal $16 112%
Kaiser Medi-Cal Ip/Op Only $16 112%
Medi-Cal $16 112%
Scan-All Plans $17 119%
Kaiser Mcal Pediatric Ip/Op Only $18 126%
Western Growers-All Plans $18 126%
Clinicas Comm - All Other Plans $19 133%
Imperial-All Plans $19 133%
Ntwrk Provdrs-All Plans $19 133%
Clinicas Mcal $20 140%
Multiplan/Claritev-All Plans $20 - $98 140%
Three Rivers Ip/Op Only-All Plans $20 - $98 140%
Americas Hp Comm Ip/Op Only-All Other Plans $21 147%
Americas Hp Mcal Ip/Op Only $21 147%
Ppo Next Ip/Op Only-All Plans $22 - $111 154%
Blue Cross Blue Shield $23 - $114 161%
Gold Coast Medi-Cal-All Plans $25 - $29 175%
Kaiser Mcr Pediatric Ip/Op Only $25 - $123 175%
Medicare (plans) $25 - $123 175%
Cigna $26 182%
Hpn Comm Ip/Op Only-All Other Plans $36 - $175 252%
Blue Shield Comm - All Other Plans $48 336%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals