CMS Price Transparency Data

Hepatitis C antibody test

Facility: Boone County Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $18
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Boone County Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.26x the Medicare baseline. Located in 1015 Union Street, Boone, IA.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $19 (133%)
Insurance Median: $18 (126%)
Cash: $19 (133% of Medicare)
Ins. Median: $18 (126% 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
Va Ccn-All Plans $3 21%
Aetna $10 - $19 70%
Amerigroup Mcr Adv - All Other Plans $10 - $37 70%
Choice Care Mcr Adv - All Plans $10 - $36 70%
Humana $10 - $79 70%
Iowa Hlth Adv - All Plans $10 70%
Mt Carmel Hp - All Plans $10 70%
UnitedHealthcare $10 - $36 70%
Iowa Total Care Mcaid - All Plans $11 - $40 77%
Medicaid / KanCare $11 77%
Meridian Mcaid - All Plans $11 77%
Tricare $14 98%
Healthsmart Accell Network $17 119%
Medical Associates Hp-All Plans $18 126%
Healthsmart Ppo - All Other Plans $19 133%
Health Alliance-All Plans $22 154%
Midlands Choice-All Plans $22 - $81 154%
Mutually Preferred-All Plans $23 - $84 161%
Wellmark Hmo $45 315%
Wellmark Ppo - All Other Plans $49 343%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1015 Union Street, Boone, IA 50036
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals