CMS Price Transparency Data

Hepatitis C antibody test

Facility: Jefferson County Health Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $47
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 3.29x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Jefferson County Health Center is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.29x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $66 (463%)
Insurance Median: $47 (329%)
Cash: $66 (463% of Medicare)
Ins. Median: $47 (329% 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 329% of the Medicare baseline (a markup of 229%). 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
UnitedHealthcare $16 - $99 112%
Tricare $43 301%
Amerigroup Mcr Adv $44 308%
Humana $44 308%
Iowa Total Care Comm - All Other Plans $44 308%
Iowa Total Care Mcr $44 308%
Molina Mcr Adv $44 308%
Iowa Total Care Mcaid $46 322%
Molina Mcaid/Chip $46 322%
Wellmark Hmo $46 322%
Medicaid / KanCare $47 329%
Wellmark Indemnity/Ppo - All Other Plans $51 357%
Aetna $54 - $99 378%
Medicare (plans) $54 378%
Midlands New Product $90 631%
Coventry Commercial Hmo $94 659%
Coventry Commercial Ppo - All Other Plans $99 694%
Midlands Choice-All Other Plans $99 694%
Molina Marketplace - All Other Plans $110 771%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals