CMS Price Transparency Data

Hepatitis C antibody test

Facility: Adventist Health Reedley

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $21
  • Cash Discount Price: $29
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Adventist Health Reedley is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.47x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$29

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $29 (203%)
Insurance Median: $21 (147%)
Cash: $29 (203% of Medicare)
Ins. Median: $21 (147% 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

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 $2 - $32 14%
Bc Mcal $5 35%
Healthnet- All Other Plans $5 - $93 35%
UnitedHealthcare $5 - $90 35%
Blue Shield Epn - All Other Plans $6 - $95 42%
Blue Shield Non Epn $6 - $110 42%
Kaiser - All Other Plans $6 - $107 42%
Western Growers/Pinnacle- All Plans $6 - $98 42%
Cigna $8 - $139 56%
Physicians Med Group Op/Profee Only- All Plans $10 - $171 70%
Cal Viva Hlth Mcal - All Plans $13 - $16 91%
Community Care Ipa Mcal-All Plans $13 - $21 91%
Dignity Mcal Op/Profee Only-All Other Plans $13 - $18 91%
Kern Health Systems Mcal-All Plans $13 - $16 91%
Medi-Cal $13 - $16 91%
Blue Shield Mcare $14 98%
Dignity Mcr Adv Op/Profee Only $14 98%
Fhcn Pace Mcr Adv-All Plans $14 98%
Healthnet- Mcr Adv $14 98%
Kaiser Mcr Adv $14 98%
Phs Prime Health Srvcs $14 98%
Tricare $14 98%
Bright Health Mcr Adv - All Plans $22 154%
Aetna $24 - $83 168%
Ah Employee Health Plan - All Plans $26 182%
Blue Cross Blue Shield $61 - $177 427%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals