CMS Price Transparency Data
Hepatitis C antibody test
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $13
- Cash Discount Price: $20
- vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at AHMC Anaheim Regional Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.91x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$20
Average discount available for prompt cash payment at this facility.
Insurance Median
$13
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: $20 (140%)
Insurance Median: $13 (91%)
Cash: $20 (140% of Medicare)
Ins. Median: $13 (91% 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.
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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 |
|---|---|---|
| Advance Clinical Research Institute | $2 - $26 | 14% |
| Ahmc Reciprocity Agreement | $2 - $26 | 14% |
| Memorial Healthcare Ipa | $2 - $26 | 14% |
| Netcare Life And Health Insurance | $2 - $22 | 14% |
| Medical Acquisition Company | $3 - $35 | 21% |
| Davita Heatlhcare Partners Plan Inc | $4 - $48 | 28% |
| Genesis Healthcare Ipa Ancillary | $4 - $53 | 28% |
| Healthcare Partners Commercial | $4 - $48 | 28% |
| Huntington Memorial Hospital | $4 - $48 | 28% |
| Medicare (plans) | $4 - $44 | 28% |
| Monarch Health Plan | $4 - $60 | 28% |
| Affiliated Health Fund | $5 - $62 | 35% |
| Allnet Preferred Provider | $5 - $62 | 35% |
| Care First | $5 - $62 | 35% |
| Interplan | $5 - $62 | 35% |
| Orange County Preferred Provider Organization | $5 - $66 | 35% |
| Private Healthcare Systems | $5 - $62 | 35% |
| Capp Care | $6 - $66 | 42% |
| Choicecare | $6 - $66 | 42% |
| Corvel | $6 - $66 | 42% |
| First Health | $6 - $75 | 42% |
| Health Net Inc | $6 - $68 | 42% |
| Multiplan Inc | $6 - $66 | 42% |
| National Provider Network | $6 - $70 | 42% |
| Three Rivers Providers Network | $6 - $70 | 42% |
| Aetna | $7 - $78 | 49% |
| Aids Health Foundation | $7 - $14 | 49% |
| Alignment Health Plan | $7 - $14 | 49% |
| Allied Physicians | $7 - $21 | 49% |
| Alta Los Angeles Hospital | $7 - $13 | 49% |
| Altamed Health Network | $7 - $14 | 49% |
| Apa Aco Inc | $7 - $14 | 49% |
| Avanti | $7 - $17 | 49% |
| Beverly Hospital | $7 - $16 | 49% |
| Blue Cross Blue Shield | $7 - $51 | 49% |
| Blue Shield Of California | $7 - $192 | 49% |
| Brand New Day | $7 - $18 | 49% |
| California Health Plan | $7 - $14 | 49% |
| Caloptima | $7 - $18 | 49% |
| Central Health Of California | $7 - $14 | 49% |
| Health Payors Organization | $7 - $79 | 49% |
| Healthcare Partners | $7 - $14 | 49% |
| Healthnet | $7 - $14 | 49% |
| Heritage Provider Network | $7 - $19 | 49% |
| Humana | $7 - $14 | 49% |
| Kaiser Foundation Hospitals | $7 - $14 | 49% |
| Nchp | $7 - $15 | 49% |
| Pacificare | $7 - $14 | 49% |
| Prospect Health Plan | $7 - $19 | 49% |
| Scan Health Plan | $7 - $14 | 49% |
| Seoul Medical Group | $7 - $14 | 49% |
| Tricare | $7 - $15 | 49% |
| Wellcare | $7 - $14 | 49% |
| Ahmc Health Self-Insurance Epo | $8 - $18 | 56% |
| Align Senior Care | $8 - $15 | 56% |
| Angels Baseball Workers Comp | $8 - $15 | 56% |
| Applecare Medical Group | $8 - $13 | 56% |
| Athens Administrators | $8 - $17 | 56% |
| Cigna | $8 - $17 | 56% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $8 - $14 | 56% |
| Emanate Health | $8 - $18 | 56% |
| Health Net | $8 - $13 | 56% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $8 - $14 | 56% |
| Healthy Way La | $8 - $13 | 56% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $8 - $14 | 56% |
| Hollywood Presbyterian Medpoint Mcal | $8 - $14 | 56% |
| Innovative Integrated Health (Iih)/Orange County Pace | $8 - $14 | 56% |
| Knox-Keene Act | $8 - $18 | 56% |
| Marriot Intl | $8 - $17 | 56% |
| Medi-Cal | $8 - $14 | 56% |
| Medical Safety Net Program | $8 - $13 | 56% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $8 - $14 | 56% |
| Non Contracted Commercial | $8 - $88 | 56% |
| Non Contracted Medi-Cal | $8 - $13 | 56% |
| Non Contracted Workers Comp | $8 - $17 | 56% |
| Private Pay Flat Rate | $8 - $14 | 56% |
| Prospect Medical Group | $8 - $13 | 56% |
| Self-Pay | $8 - $14 | 56% |
| Talbert Medical Group | $8 - $14 | 56% |
| Veterans Administration | $8 - $10 | 56% |
| Affiliated Doctors Of Orange County | $11 | 77% |
| UnitedHealthcare | $29 - $57 | 203% |
| Monarch Healthcare Medical Group | $36 | 252% |
| Msi/Medical Services For Indigents | $52 | 364% |