CMS Price Transparency Data

Hepatitis C antibody test

Facility: Loma Linda University Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $76
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 5.33x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Loma Linda University Medical Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.33x the Medicare baseline. Located in 11234 Anderson St, Loma Linda, CA.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$76

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: $63 (441%)
Insurance Median: $76 (533%)
Cash: $63 (441% of Medicare)
Ins. Median: $76 (533% 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 533% of the Medicare baseline (a markup of 433%). 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
UnitedHealthcare $12 - $14 84%
Adventist Health $14 - $64 98%
Alpha Care Medical Group $14 - $21 98%
Dignity Health $14 - $21 98%
Epic Health Plan $14 - $128 98%
Inland Empire Health Plan (Iehp) $14 - $22 98%
Kaiser Foundation Hospitals $14 - $213 98%
Upland Medical Group $14 98%
Vantage Medical Group $14 - $21 98%
Prime Health Services $15 - $271 105%
Riverside University Health System $16 112%
Molina Healthcare Of Ca $19 133%
Blue Cross Blue Shield $20 - $100 140%
Heritage Provider Network $23 161%
Lluh Dept Of Risk Management $25 - $64 175%
Blue Shield Of California $50 - $86 350%
Global Benefits Group $76 - $191 533%
Temecula Valley Physicians Medical Group $76 - $85 533%
Trivalley Medical Group $76 - $85 533%
Aetna $77 - $86 540%
Cigna $81 - $104 568%
Networks By Design $82 - $207 575%
Multiplan $94 - $239 659%
Central Health Plan $101 - $255 708%
Galaxy Health $107 - $271 750%
Health Management Network $113 - $287 792%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11234 Anderson St, Loma Linda, CA 92354
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals