CMS Price Transparency Data

Hepatitis C antibody test

Facility: Eastern Idaho Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $130
  • Cash Discount Price: $309
  • vs. Medicare Baseline: 9.11x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Eastern Idaho Regional Medical Center is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 9.11x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.
Cash / Self-Pay
$309

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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: $309 (2165%)
Insurance Median: $130 (911%)
Cash: $309 (2165% of Medicare)
Ins. Median: $130 (911% 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 911% of the Medicare baseline (a markup of 811%). 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
Blue Cross Blue Shield $12 - $293 84%
Molina $12 - $14 84%
Prime Health $14 - $262 98%
Regence Blue Shield $14 98%
Rexburg Care And Rehab $14 98%
Triwest Healthcare Alliance $14 98%
United $14 - $178 98%
Veteran'S Administration $14 98%
Humana $15 - $259 105%
Regence $22 154%
Select Health $93 652%
Select Health Ichn Brightpath $93 - $104 652%
Select Health Idaho (Eirmc Only) $98 687%
Aetna $122 - $150 855%
Doug Andrus Distributing $123 862%
Pacificsource Health $130 - $165 911%
University Of Utah $130 911%
Mountain Health Co-Op $154 - $231 1079%
Cigna $170 1191%
First Choice Health Of Washington $185 1296%
Moda $192 1345%
Dmba $199 1395%
Geha Ppo Usa $247 1731%
Multiplan $259 - $278 1815%
First Choice Of The Midwest $278 1948%
Interwest Health $278 1948%
St. John'S Health Network $278 1948%
Coventry First Health $281 1969%
Shashone-Bannock Tribal Health $309 2165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Channing Way, Idaho Falls, ID 83404
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals