CMS Price Transparency Data

Hepatitis C antibody test

Facility: Grinnell Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $19
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Grinnell Regional Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.33x the Medicare baseline. Located in 210 Fourth Avenue, Grinnell, IA.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $49 (343%)
Insurance Median: $19 (133%)
Cash: $49 (343% of Medicare)
Ins. Median: $19 (133% 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
UnitedHealthcare $9 - $44 63%
Blue Cross Blue Shield $14 - $15 98%
Wellmark Uph Self-Funded $14 98%
Aetna $15 - $58 105%
Amerivantage $15 105%
Humana $15 105%
Molina $15 105%
Cigna $19 - $38 133%
Health Partners Open Network $19 - $22 133%
Medica Exchange Inspire $22 154%
Medica Exchange Insure $24 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 210 Fourth Avenue, Grinnell, IA 50112
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals