CMS Price Transparency Data

Hepatitis C antibody test

Facility: Clarinda Regional Health Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $74
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 5.19x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Clarinda Regional Health Center is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.19x the Medicare baseline. Located in 220 Essie Davison Drive, Clarinda, IA.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $84 (589%)
Insurance Median: $74 (519%)
Cash: $84 (589% of Medicare)
Ins. Median: $74 (519% 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 519% of the Medicare baseline (a markup of 419%). 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
Ambetter / Centene $68 - $74 477%
Molina Mcr Adv-All Plans $68 477%
UnitedHealthcare $68 - $135 477%
Blue Cross Blue Shield $69 - $113 484%
Ia Total Care Mcaid-All Plans $74 519%
Geha-All Plans $132 925%
Coventry Health-All Other Plans $133 932%
Midlands Choice-All Plans $135 946%
Multiplan-All Plans $135 946%
Amerigroup Ia Mcaid-All Plans $142 995%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 220 Essie Davison Drive, Clarinda, IA 51632
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals