CMS Price Transparency Data

Hepatitis C antibody test

Facility: Casa Colina Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $15
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Casa Colina Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$19

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: $19 (133%)
Insurance Median: $15 (105%)
Cash: $19 (133% 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.

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
Heritage Prvdr Ntwrk Mcal $11 77%
Prospect Hp Mcal $13 91%
UnitedHealthcare $13 - $14 91%
Aetna $14 - $31 98%
Blue Cross Blue Shield $14 - $25 98%
Blue Shield Mcr Adv $14 98%
Caremore Mcr Adv - All Plans $14 98%
Central Hlth Plan - All Plans $14 98%
Doctors Managed Op Only - All Plans $14 98%
Empire Healthcare Op Only - All Plans $14 98%
Epic Comm - All Other Plans $14 98%
Epic Mcr Adv $14 98%
Focus Healthcare Wc - All Plans $14 98%
Healthnet Mcr Adv $14 98%
Humana $14 - $21 98%
Iehp - All Other Plans $14 98%
Iehp Mcr Adv $14 98%
Kaiser Comm - All Other Plans $14 98%
Kaiser Mcr Adv $14 98%
Premiercare Op Only - All Plans $14 98%
Promed Hlth Ntwrk Op Only - All Plans $14 98%
Prospect Hp Mcr Adv $14 98%
Triwest - All Plans $14 98%
Wellcare Mcr Adv - All Plans $14 98%
Medi-Cal $16 112%
Prospect Hp Comm - All Other Plans $16 112%
Heritage Prvdr Ntwrk Comm - All Other Plans $17 119%
Heritage Prvdr Ntwrk Mcr $17 119%
Affiliated Hlth Funds - All Plans $18 126%
Healthnet Comm - All Other Plans $18 126%
Kaiser Mcal $18 126%
Cigna $21 147%
Corvel - All Plans $21 147%
Coventry - All Plans $21 147%
Multiplan - All Plans $21 147%
Three Rivers - All Plans $21 147%
Brand New Day Mcr Adv - All Plans $26 182%
Galaxy Provdr Ntwrk - All Plans $30 210%
Healthcare Partners - All Other Plans $34 238%
Healthcare Partners Mcr $34 238%
Primecare Comm - All Other Plans $34 238%
Primecare Mcr Adv $34 238%
Prospect Med Grp Alta - All Plans $36 252%
Iehp Mcal $41 287%
Blue Shield Comm - All Other Plans $63 441%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals