CMS Price Transparency Data
Hepatitis C antibody test
Facility: Garfield Medical Center
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $25
- vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Garfield Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$25
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: $25 (175%)
Insurance Median: $14 (98%)
Cash: $25 (175% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Access Ipa Ancillary | $2 - $100 | 14% |
| Associated Hispanic Phys Of So Cal | $2 - $67 | 14% |
| Care First Health Plan | $2 - $33 | 14% |
| Employee Health Systems Mg | $2 - $67 | 14% |
| Pacific Independent Physician Association | $2 - $53 | 14% |
| UnitedHealthcare | $2 - $200 | 14% |
| Ahmc Healthcare Inc | $3 - $100 | 21% |
| Family Health Alliance | $3 - $100 | 21% |
| Allied Physicians Risk Pool | $4 - $117 | 28% |
| Allied Physicians Risk Pool Agreement | $4 - $117 | 28% |
| Central Health Plan | $4 - $134 | 28% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $4 - $134 | 28% |
| Health Net Foundation M Cal (Family Health Alliance) | $4 - $134 | 28% |
| Healthnet Medi Cal Cap | $4 - $117 | 28% |
| Molina Medical Group | $4 - $130 | 28% |
| Phys Assoc Of San Gab Valley | $4 - $134 | 28% |
| Pipa Risk Pool Agreement | $4 - $117 | 28% |
| Allied Physicians Med Grp | $5 - $167 | 35% |
| Blue Cross Blue Shield | $5 - $167 | 35% |
| Blue Shield Of California | $5 - $180 | 35% |
| Health Net | $5 - $281 | 35% |
| Alhambra Hospital | $6 - $200 | 42% |
| Care 1St Health Plan | $6 - $200 | 42% |
| Health Net Comm/Hmo | $6 - $184 | 42% |
| Interplan | $6 - $250 | 42% |
| La Care Health Plan | $6 - $184 | 42% |
| Aetna | $7 - $243 | 49% |
| First Health Network | $7 - $234 | 49% |
| One Health Plan | $7 - $234 | 49% |
| Americas Health Plan | $8 - $284 | 56% |
| Corvel Corporation | $8 - $267 | 56% |
| Fmc Los Angeles Co Epo | $8 - $250 | 56% |
| Multiplan | $8 - $284 | 56% |
| Health Payors Organization | $9 - $301 | 63% |
| Advantage Care Ipa | $10 - $334 | 70% |
| Ahmc Health Epo | $10 - $18 | 70% |
| Aids Health Foundation | $10 - $14 | 70% |
| Alignment Health Plan | $10 - $15 | 70% |
| Allied Physicians | $10 - $21 | 70% |
| Apa Aco Inc | $10 - $14 | 70% |
| Athens Administrators | $10 - $17 | 70% |
| Avanti | $10 - $17 | 70% |
| Beverly Hospital | $10 - $16 | 70% |
| Blue Shield | $10 - $201 | 70% |
| Brand New Day | $10 - $18 | 70% |
| Caloptima Direct | $10 - $21 | 70% |
| Care 1St Mcl/Gar Cap Reciprocity | $10 - $13 | 70% |
| Cms | $10 - $14 | 70% |
| Community Health Plan | $10 - $13 | 70% |
| Cv-19 Hrsa Uninsured Testing And Tx | $10 - $14 | 70% |
| East La Reg Ctr | $10 - $334 | 70% |
| Easy Choice Health Plan | $10 - $14 | 70% |
| Emanate Health | $10 - $18 | 70% |
| Healthy Way La | $10 - $13 | 70% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $10 - $14 | 70% |
| Hollywood Presbyterian Medpoint Mcal | $10 - $14 | 70% |
| Humana | $10 - $14 | 70% |
| Inter Valley Health Plan | $10 - $15 | 70% |
| Knox-Keene Act | $10 - $18 | 70% |
| La Care Covered Direct | $10 - $14 | 70% |
| Molina Healthcare | $10 - $15 | 70% |
| Molina Healthcare Of California | $10 - $18 | 70% |
| National Disaster Medical System | $10 - $16 | 70% |
| Non Contract Commercial | $10 - $334 | 70% |
| Non-Contract Medi-Care | $10 - $14 | 70% |
| One Legacy | $10 - $334 | 70% |
| Other Non-Contracted Workers Compensation | $10 - $17 | 70% |
| Other Non-Contracting Medi-Cal | $10 - $13 | 70% |
| Pacific Alliance Medical Center Comm/Sr | $10 - $14 | 70% |
| Physician Healthways Medical Corporation | $10 - $16 | 70% |
| Physicians Healthways Medi-Cal | $10 - $334 | 70% |
| Physicians Healthways Medical Corporation | $10 - $334 | 70% |
| Preferred Health Network | $10 - $16 | 70% |
| Private Pay | $10 - $334 | 70% |
| San Miguel Health Plan | $10 - $16 | 70% |
| Scan Health Plan Sr Hmo | $10 - $14 | 70% |
| Self-Pay | $10 - $14 | 70% |
| State Of California Medi-Cal | $10 - $14 | 70% |
| Ucla Impact Dept Of Uncology | $10 - $14 | 70% |
| Veterans Administration | $10 | 70% |
| Chinatown Service Center Pace | $12 - $17 | 84% |
| Cigna | $16 | 112% |
| Health Net Inc | $16 - $23 | 112% |
| Pacificare Of California Inc | $29 | 203% |
| Pacificare Ppo | $29 | 203% |