CMS Price Transparency Data

Hepatitis C antibody test

Facility: Portneuf Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $275
  • Cash Discount Price: $194
  • vs. Medicare Baseline: 19.27x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Portneuf Medical Center is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 19.27x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$194

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

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: $194 (1359%)
Insurance Median: $275 (1927%)
Cash: $194 (1359% of Medicare)
Ins. Median: $275 (1927% 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 1927% of the Medicare baseline (a markup of 1827%). 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
Aetna $67 - $275 470%
Healthscope Benefits [2290] $67 470%
UnitedHealthcare $67 - $292 470%
Black Lung [6055] $133 932%
Employee Benefit Management Services [2445] $133 - $194 932%
Healthcare Highways [2210] $133 - $308 932%
Lucent Health [6000] $133 932%
Moda Health [6100] $133 932%
Oncology Patient Assistance Programs [2295] $133 932%
Pending Ssi [1616] $133 932%
Web Tpa [2115] $133 932%
Pacific Source Health Plans [2850] $186 1303%
Liberty Health Share Lhs/Medcost Solutions Llc [2400] $194 1359%
Medishare Christian Care [1645] $194 1359%
Multiplan [1680] $217 - $308 1521%
Worker'S Comp [2125] $236 - $243 1654%
Cigna $238 1668%
Enablecomp [1350] $243 1703%
Transamerican Life [1990] $243 1703%
First Health [1375] $267 1871%
Mailhandlers [1595] $275 1927%
Selecthealth [3740] $275 - $292 1927%
Geha [1415] $292 2046%
Humana $292 2046%
Administrative Concepts [1005] $308 2158%
Healthfirst [2395] $308 2158%
Healthnet [1495] $308 2158%
Hometown Health [2155] $308 2158%
Mayo Clinic Health Solutions [2280] $308 2158%
Meritain Health [1655] $308 2158%
Mutual Of Omaha [1685] $308 2158%
National Association Of Letter Carriers [1695] $308 2158%
New Era Life Insurance Company [1705] $308 2158%
Pan American Life Insurance Co [1770] $308 2158%
Pba [1775] $308 2158%
Phcs [1780] $308 2158%
Planned Administrators Inc [2360] $308 2158%
Trustmark [2030] $308 2158%
Ut Id Teamsters [3760] $308 2158%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals