CMS Price Transparency Data

Hepatitis C antibody test

Facility: AHMC Seton Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $18
  • Cash Discount Price: $240
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at AHMC Seton Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.26x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$240

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $240 (1682%)
Insurance Median: $18 (126%)
Cash: $240 (1682% of Medicare)
Ins. Median: $18 (126% 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
Veterans Administration (Va) $10 70%
Medi-Cal $13 91%
Aetna $14 - $43 98%
Apcmg $14 - $21 98%
Asian American Medical Group $14 - $18 98%
Blue Cross Blue Shield $14 - $228 98%
Blue Shield Of California $14 - $182 98%
Brand New Day $14 - $18 98%
Brown And Toland Medical Group $14 - $18 98%
Canopy Health $14 - $26 98%
Care Advantage $14 98%
Chinese Community Health Plan $14 - $150 98%
Cmac $14 98%
Covid-19 Uninsured Program $14 98%
For Your Benefit $14 98%
Healthnet Seniority $14 98%
Hill Physicians Medical Group Inc $14 - $16 98%
Humana $14 98%
Imperial Health Plan $14 98%
Jade Health Care Mg $14 - $150 98%
Kaiser $14 - $246 98%
Medicare (plans) $14 98%
North East Medical Services $14 - $18 98%
Pacificare $14 98%
UnitedHealthcare $14 - $29 98%
Central Health Plan $15 105%
Easy Choice Hospital Services $15 105%
San Mateo County/San Mateo County General Hospital $15 105%
Athens Administrators $17 119%
Corvel Healthcare $17 119%
Multiplan/Bce Emergis $17 - $225 119%
Tricare $17 119%
Work Comp Other $17 119%
Ahmc Health $18 126%
Health Plan Of San Mateo Healthworx $18 126%
Knox-Keene Act $18 126%
San Francisco Health Plan $18 126%
Health Plan Of San Mateo $20 140%
Self Pay $45 - $102 315%
Cigna $75 526%
Interplan Corporation $180 1261%
Healthcare Foundation Of San Mateo $210 - $225 1472%
Private Healthcare Sytems Inc $225 1577%
The First Health Network $225 1577%
Health Net $230 1612%
Beech Street Corporation $240 1682%
Choicecare Network $255 1787%
Multiplan $255 1787%
Mills Peninsula Health Services $270 1892%
Indemnity $300 2102%
Workers Compensation Federal $300 2102%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals