CMS Price Transparency Data

Hepatitis C antibody test

Facility: Valley Children's Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $6
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.42x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Valley Children's Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.42x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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%)
Insurance Median: $6 (42%)
Ins. Median: $6 (42% 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
Health Net $3 - $5 21%
Allcare Ipa $4 - $20 28%
Central Valley Medical Providers Ipa $4 - $30 28%
Community Health $4 28%
Dignity Health Central Coast $4 28%
Physicians Choice Medical Group $4 28%
Stanislaus Partners In Health $4 28%
United Physicians Network Ipa $4 - $31 28%
Aetna $5 35%
Blue Cross Blue Shield $5 - $141 35%
Blue Shield $5 - $6 35%
Dignity (Formerly Managed Care Systems) $5 35%
Fowler Packing $5 35%
Health Plan Of San Joaquin $5 35%
Kaiser $5 - $29 35%
Kern Legacy $5 35%
UnitedHealthcare $5 - $31 35%
Bakersfield Family Medical Group $6 42%
Community Care Health Plan $6 42%
First Health Formerly Coventry $6 42%
Health Smart $6 42%
Key Medical Ipa $6 42%
Network By Design $6 42%
Sutter Health $7 49%
Multiplan $8 56%
Central California Alliance For Health $28 196%
Dignity Ipa_Formerly Img $28 196%
La Salle Ipa $28 196%
Sante Ipa $28 196%
Sequoia Health Ipa $30 210%
Univseral Healthcare Ipa $30 210%
Community Care Ipa $32 224%
Adventist $36 252%
Cencal Health $40 280%
Kern Family Health Care $40 280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens