CMS Price Transparency Data

Hepatitis C antibody test

Facility: Adventist Health Vallejo

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Adventist Health Vallejo is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.
Cash / Self-Pay
$16

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: $16 (112%)
Insurance Median: $14 (98%)
Cash: $16 (112% 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

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
Healthnet-All Plans $2 - $28 14%
Blue Shield Behav Hlth $6 - $89 42%
Blue Shield Epn $6 - $93 42%
Blue Shield Non-Epn-All Other Plans $6 - $91 42%
UnitedHealthcare $6 - $126 42%
Phcs-All Plans $7 - $108 49%
Western Growers-All Plans $7 - $104 49%
Interplan-All Plans $8 - $128 56%
Beech Street-All Plans $9 - $148 63%
Choicecare-All Plans $9 - $138 63%
Cigna $10 - $158 70%
Galaxy Network-All Plans $11 - $177 77%
Health Management Network-All Plans $11 - $167 77%
Kaiser-All Plans $11 - $165 77%
Three Rivers-All Plans $11 - $177 77%
Medi-Cal $13 - $16 91%
Va Medi-Cal $13 - $16 91%
Blue Shield Mcr Adv $14 98%
Medicare (plans) $14 98%
Napa County Mcal Child $14 98%
Tricare $14 98%
Va Mcr-All Other Plans $14 98%
Ah Employee Health Plan-All Plans $26 182%
Aetna $84 589%
Blue Cross Blue Shield $133 - $160 932%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 Oregon St, Vallejo, CA 94590
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric