CMS Price Transparency Data
Hepatitis C antibody test
Facility: John Muir Medical Center - Concord Campus
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $7
- vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at John Muir Medical Center - Concord Campus is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$7
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: $7 (49%)
Insurance Median: $14 (98%)
Cash: $7 (49% 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 |
|---|---|---|
| Aps Healthcare [1003103] | $2 - $46 | 14% |
| Carecentrix [1011001] | $2 - $41 | 14% |
| Carelon Behavioral Health [1050104] | $2 - $56 | 14% |
| Cigna | $2 - $73 | 14% |
| Fortified Provider Network [1063104] | $2 - $56 | 14% |
| Generic Commercial/Indemnity [1017001] | $2 - $41 | 14% |
| Medigap [1036001] | $2 - $56 | 14% |
| Three Rivers Provider Network [1073104] | $2 - $56 | 14% |
| United Behavioral Health [1048103] | $2 - $51 | 14% |
| UnitedHealthcare | $2 - $59 | 14% |
| Aetna | $3 - $73 | 21% |
| Blue Cross Blue Shield | $3 - $186 | 21% |
| Blue Shield Hmo [1006103] | $3 - $65 | 21% |
| Blue Shield Ppo [1006104] | $3 - $75 | 21% |
| Blue Shield-Network [1006026] | $3 - $65 | 21% |
| Contra Costa Health Plan Hmo [1013103] | $3 - $61 | 21% |
| Health Net Hmo [1028103] | $3 - $58 | 21% |
| Health Net Ppo [1028104] | $3 - $74 | 21% |
| Health Net-Network [1028026] | $3 - $58 | 21% |
| Kaiser Hmo [1033103] | $3 - $75 | 21% |
| Western Health Advantage Hmo [1053103] | $3 - $81 | 21% |
| Federal Correction Institute [1062104] | $4 - $81 | 28% |
| First Health [1016104] | $4 - $86 | 28% |
| Galaxy Health Network [1064104] | $4 - $91 | 28% |
| Health Management Network [1066104] | $4 - $86 | 28% |
| Healthcomp [1089104] | $4 - $186 | 28% |
| Healthsmart - Pka Interplan [1031104] | $4 - $81 | 28% |
| Humana | $4 - $84 | 28% |
| Integrated Health Plan [1075104] | $4 - $91 | 28% |
| Medicare (plans) | $4 - $81 | 28% |
| Networks By Design [1084104] | $4 - $81 | 28% |
| Pponext [1072104] | $4 - $81 | 28% |
| Sutter Preferred Health Plan [1044104] | $4 - $81 | 28% |
| Contra Costa County Jail [1012104] | $13 | 91% |
| Alignment Health [1177113] | $14 | 98% |
| Blue Shield-Network Mcare [1006127] | $14 | 98% |
| Care 1St Health Plan [1094113] | $14 | 98% |
| Caremore [1171113] | $14 | 98% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] | $14 | 98% |
| Easy Choice Health Plan [1083113] | $14 | 98% |
| Essence Healthcare [1049028] | $14 | 98% |
| Essence Healthcare [1049128] | $14 | 98% |
| Golden State-Network Mcare [1023127] | $14 | 98% |
| Health Net-Network Mcare [1028127] | $14 | 98% |
| Hospice Of East Bay [1085104] | $14 | 98% |
| Scan-Network Mcare [1043127] | $14 | 98% |
| Veterans Administration [1051113] | $14 | 98% |
| Jmpn Canopy Hn [1640000011] | $16 | 112% |
| Workers' Comp [1024005] | $17 | 119% |
| Generic Hmo [1018103] | $18 | 126% |
| Generic Ppo [1021104] | $18 | 126% |
| Canopy Hn Hmo [1166103] | $26 | 182% |
| Brms [1091104] | $186 | 1303% |
| Delta Health Systems [1032104] | $186 | 1303% |
| Empire Plan [1092104] | $186 | 1303% |
| Donor Network West [1008103] | $12,000 | 84093% |