CMS Price Transparency Data

Hepatitis C antibody test

Facility: Adventist Health Tehachapi Valley

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $37
Cash Discount Price: $52
vs. Medicare Baseline: 2.59x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Adventist Health Tehachapi Valley is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.59x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $52 (364%)

Insurance Median: $37 (259%)

Cash: $52 (364% of Medicare)

Ins. Median: $37 (259% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 259% of the Medicare baseline (a markup of 159%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 Mcare	$2 - $50	14%
Medicare (plans)	$2 - $50	14%
Tricare	$2 - $50	14%
UnitedHealthcare	$2 - $129	14%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$2 - $50	14%
Network Providers- All Plans	$3 - $64	21%
Kaiser Ip/Op Only- All Other Plans	$4 - $86	28%
Blue Shield Epn- All Other Plans	$5 - $112	35%
Centivo - All Plans	$5 - $113	35%
Western Grwrs/Pinnacle - All Plans	$5 - $111	35%
Blue Shield Non-Epn	$6 - $132	42%
Klhp-Kern Legacy Epo -All Other Plans	$6 - $132	42%
Ah Employee Health Plan - All Plans	$7 - $140	49%
Blue Cross Blue Shield	$7 - $152	49%
Cigna	$10 - $206	70%
Healthnet- All Other Plans	$10 - $203	70%
Coventry- All Plans	$11 - $238	77%
Bc Mcal	$13 - $17	91%
Healthnet Medi-Cal	$13 - $20	91%
Kaiser Medi-Cal Ip/Op Only	$13 - $16	91%
Khs-Kern Hlth Systm Mcal	$13 - $21	91%
Medi-Cal	$13 - $16	91%
Universal Ipa Mcal Op/Profee Only	$13 - $16	91%
Oscar Health Plan- All Plans	$23	161%
Aetna	$84	589%

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 $52.
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 Tehachapi Valley 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.