CMS Price Transparency Data

Hepatitis C antibody test

Facility: Adventist Health White Memorial Montebello

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $15
Cash Discount Price: $14
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Adventist Health White Memorial Montebello is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 309 W Beverly Blvd, Montebello, CA.

Cash / Self-Pay

$14

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $14 (98%)

Insurance Median: $15 (105%)

Cash: $14 (98% of Medicare)

Ins. Median: $15 (105% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 Salud	$8	56%
Aetna	$9 - $14	63%
Healthcare Partners-All Plans	$12	84%
Alignment Health Plan-All Plans	$14	98%
Altamed Mcare-All Other Plans	$14	98%
Blue Shield Mcare Adv	$14	98%
Brand New Day Mcare-All Other Plans	$14	98%
Brandman Health Plan-All Plans	$14	98%
Caremore-All Plans	$14	98%
Clever Care Hp-All Plans	$14	98%
Easy Choice Mcare Adv-All Plans	$14	98%
Healthnet Med Adv	$14	98%
Kaiser Mcare Adv	$14	98%
Scan Health-All Plans	$14	98%
Oscar-All Plans	$15	105%
Altamed Mcal	$16	112%
Bc Mcal	$16	112%
Blue Shield Promise Mcal	$16	112%
Brand New Day Mcal	$16	112%
Healthnet Mcal	$16	112%
Kaiser Mcal	$16	112%
La Care Mcal	$16	112%
Medi-Cal	$16	112%
Molina Mcal - All Plans	$16	112%
Blue Cross Blue Shield	$17	119%
Blue Shield Epn Ifp	$20	140%
Cigna	$26	182%
Blue Shield Epn Core	$271	1899%
Blue Shield Comm - All Other Plans	$281	1969%
Healthnet Comm-All Other Plans	$515	3609%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $14.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health White Memorial Montebello is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.