CMS Price Transparency Data

Hepatitis C antibody test

Facility: Adventist Health Lodi Memorial

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $8
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Adventist Health Lodi Memorial is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$8

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $8 (56%)
Insurance Median: $14 (98%)
Cash: $8 (56% of Medicare)
Ins. Median: $14 (98% 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
Medcore(Omni Ipa) Op Only- All Plans $3 - $52 21%
Blue Shield Epn - All Other Plans $4 - $65 28%
Blue Shield Non-Epn $4 - $68 28%
Bc Mcal $5 35%
Kaiser Commercial - All Other Plans $5 - $82 35%
UnitedHealthcare $5 - $83 35%
Healthnet- All Other Plans $6 - $99 42%
Networks By Design- All Plans $6 - $100 42%
First Health- All Plans $10 - $165 70%
Multiplan- All Plans $10 - $161 70%
Beech Street- All Plans $11 - $181 77%
Cigna $11 - $181 77%
Three Rivers Provider Network- All Plans $11 - $181 77%
Western Growers- All Plans $11 - $181 77%
Hp Of San Joaquin Ppo - All Other Plans $12 - $191 84%
Celtic Ins Company - All Plans $13 - $18 91%
Healthnet Mcal $13 - $23 91%
Hp Of San Joaquin Mcal $13 - $20 91%
Kaiser Mcal $13 - $16 91%
Medi-Cal $13 - $16 91%
Alignment Health Plan (Ahp)-All Plans $14 98%
Blue Shield Mcare Adv $14 98%
Cca Health Plan Mcr Adv- All Plans $14 98%
Healthnet Mcare $14 98%
Hp Of San Joaquin Mcr Adv $14 98%
Humana $14 98%
Kaiser Mcr Adv $14 98%
Tricare $14 98%
Knnex Health - All Plans $17 119%
Ah Employee Health Plan - All Plans $26 182%
Bright Health - All Plans $29 203%
Aetna $47 329%
Blue Cross Blue Shield $137 - $152 960%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals