CMS Price Transparency Data

Hepatitis C antibody test

Facility: Loring Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $53
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 3.71x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Loring Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.71x the Medicare baseline. Located in 211 Highland Avenue Po Box 217, Sac City, IA.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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: $56 (392%)
Insurance Median: $53 (371%)
Cash: $56 (392% of Medicare)
Ins. Median: $53 (371% 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 371% of the Medicare baseline (a markup of 271%). 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
Meritain $14 98%
Bas $21 147%
Aetna $26 - $70 182%
Auxiant $35 245%
Blue_Cross $42 - $70 294%
Champva $42 294%
Health_Partners $42 294%
Admin_Concepts $45 315%
UnitedHealthcare $49 - $70 343%
Va $52 364%
Champus $53 371%
Humana $61 - $70 427%
Healthscope $63 441%
Midlands_Choice $66 463%
Cigna $67 470%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 211 Highland Avenue Po Box 217, Sac City, IA 50583
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals