CMS Price Transparency Data
Hepatitis C antibody test
Facility: Greater El Monte Community Hospital
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $8
- Cash Discount Price: $8
- vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Greater El Monte Community Hospital is $8. 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 0.56x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$8
Average discount available for prompt cash payment at this facility.
Insurance Median
$8
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: $8 (56%)
Cash: $8 (56% of Medicare)
Ins. Median: $8 (56% 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 |
|---|---|---|
| Ahmc Reciprocity Agreement | $2 - $8 | 14% |
| Ahmc Reciprocity Agreement Senior/Commercial | $2 - $8 | 14% |
| Allied Physicians Medical Group | $2 - $13 | 14% |
| Alta Med Health Services Med Grp | $2 - $6 | 14% |
| Bella Vista Medical Group Ipa | $2 - $11 | 14% |
| Blue Cross Blue Shield | $2 - $25 | 14% |
| Care 1St Medi Cal Hmo Cap Exceptional Care | $2 | 14% |
| Care First Health Plan | $2 | 14% |
| Employee Health Systems Medical Group | $2 - $5 | 14% |
| Global Care Medical Group Ipa | $2 - $11 | 14% |
| Good Samaritan Medical Practice Assoc | $2 - $15 | 14% |
| Lincoln Hospital Medical Center | $2 - $8 | 14% |
| Clinica Medica Familiar | $3 - $12 | 21% |
| Molina Healthcare Of California | $3 - $18 | 21% |
| Blue Shield Of California | $4 - $198 | 28% |
| California Thoroughbred Horesmans Foundation | $4 - $12 | 28% |
| Care 1St Health Plan | $4 - $15 | 28% |
| Health Net Foundation | $4 - $33 | 28% |
| La Care Health Plan | $4 - $14 | 28% |
| Universal Care | $4 - $18 | 28% |
| Central Health Plan | $5 - $25 | 35% |
| Cost Containment Strategies | $5 - $16 | 35% |
| Health Net Inc | $5 - $36 | 35% |
| In Custody Police Dept | $5 - $16 | 35% |
| Interplan | $5 - $19 | 35% |
| UnitedHealthcare | $5 - $21 | 35% |
| Community Care Network | $6 - $20 | 42% |
| Health Payors Organization | $6 - $22 | 42% |
| Multiplan | $6 - $21 | 42% |
| Pacificare Of California | $6 - $22 | 42% |
| Ahmc Health Self-Insurance Epo | $7 - $18 | 49% |
| Aids Health Foundation | $7 - $14 | 49% |
| Alignment Health Plan | $7 - $14 | 49% |
| Allied Physicians | $7 - $21 | 49% |
| Altamed Health Network | $7 - $14 | 49% |
| Apa/Aco Inc | $7 - $14 | 49% |
| Associated Hispanic Physicians | $7 - $14 | 49% |
| Athens Administrators | $7 - $17 | 49% |
| Avanti | $7 - $17 | 49% |
| Beverly Hospital | $7 - $16 | 49% |
| Brand New Day | $7 - $18 | 49% |
| Caloptima | $7 - $18 | 49% |
| Champus Foundation | $7 - $16 | 49% |
| Cms | $7 - $14 | 49% |
| Commercial Non Contract | $7 - $25 | 49% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $7 - $14 | 49% |
| Easy Choice Health Plan | $7 - $14 | 49% |
| Emanate Health | $7 - $18 | 49% |
| Healthy Way La | $7 - $13 | 49% |
| Hollywood Presbyterian Adv Med Mcal | $7 - $14 | 49% |
| Hollywood Presbyterian Medpoint Mcal | $7 - $14 | 49% |
| Inter Valley Health Plan | $7 - $15 | 49% |
| Intercomp | $7 - $15 | 49% |
| Knox-Keene Act | $7 - $18 | 49% |
| La Care Covered Direct | $7 - $14 | 49% |
| Medi-Cal Sub Acute | $7 - $25 | 49% |
| Molina Healthcare | $7 - $15 | 49% |
| Nuclear Medicine/Whmc | $7 - $25 | 49% |
| One Legacy | $7 - $25 | 49% |
| Other Non Contracted Medi-Cal Hmo | $7 - $13 | 49% |
| Other Non Contracted Senior Hmo | $7 - $14 | 49% |
| Other Non Contracted Work Comp | $7 - $17 | 49% |
| Pacific Alliance Medical Center Reciprocal Contract | $7 - $14 | 49% |
| Preferred Health Network | $7 - $16 | 49% |
| San Miguel Health Plan | $7 - $16 | 49% |
| Scan Health Plan | $7 - $14 | 49% |
| Self-Pay | $7 - $14 | 49% |
| State Of California | $7 - $13 | 49% |
| Veterans Administration | $7 - $10 | 49% |
| Ahmc Healthcare Inc | $8 - $13 | 56% |
| Chinatown Service Center Pace | $8 - $17 | 56% |
| Cigna | $17 | 119% |
| In Custody-Ca Highway Patrol | $20 | 140% |