CMS Price Transparency Data

Hepatitis C antibody test

Facility: Pali Momi Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $78
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 5.47x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Pali Momi Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.47x the Medicare baseline. Located in 98-1079 Moanalua Road, Aiea, HI.
Cash / Self-Pay
$97

Average discount available for prompt cash payment at this facility.

Insurance Median
$78

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: $97 (680%)
Insurance Median: $78 (547%)
Cash: $97 (680% of Medicare)
Ins. Median: $78 (547% 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 547% of the Medicare baseline (a markup of 447%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Alohacare $14 - $20 98%
Hmsa $14 - $31 98%
Mdx $14 - $17 98%
Devoted $15 105%
Ohana $15 - $21 105%
UnitedHealthcare $20 140%
Hcha $29 203%
Pac Admin $32 224%
Verdegard $35 245%
Hwmg/Hmaa $36 252%
Uha $36 252%
Calvos $74 - $135 519%
Mimoh $74 - $135 519%
Kaiser $78 - $144 547%
Multiplan $78 - $153 547%
Coventry $83 - $153 582%
Mccp $83 - $153 582%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 98-1079 Moanalua Road, Aiea, HI 96701
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals