CMS Price Transparency Data

Hepatitis C antibody test

Facility: Hammond Henry Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $139
Cash Discount Price: $169
vs. Medicare Baseline: 9.74x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Hammond Henry Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 9.74x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$169

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $169 (1184%)

Insurance Median: $139 (974%)

Cash: $169 (1184% of Medicare)

Ins. Median: $139 (974% 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 974% of the Medicare baseline (a markup of 874%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$22 - $141	154%
Blue Cross Blue Shield	$22 - $113	154%
Meridian Health Plan-All Plans	$22	154%
Quad City Community Hc-All Plans	$27	189%
Geneseo Good Samaritan Village Op Only-All Plans	$41	287%
Tricare	$49	343%
Health Alliance Mcare Adv	$55	385%
Humana	$55 - $169	385%
UnitedHealthcare	$55 - $139	385%
Wellmark Of Ia-All Plans	$94	659%
Springfield Armory-All Plans	$122	855%
Ambetter / Centene	$132	925%
Health Alliance-All Other Plans	$141	988%
Multiplan Integrated Hp	$141	988%
Cigna	$145	1016%
Multiplan Pponext	$150	1051%
Osf Direct Access Network-All Plans	$150	1051%
Multiplan-All Other Plans	$160	1121%
Corvel-All Plans	$169	1184%
Healthsmart Adult-All Other Plans	$169	1184%
Healthsmart Pediatric	$169	1184%
Hfn-All Plans	$169	1184%
Multiplan Beech Street	$169	1184%
Multiplan Phcs Adult	$169	1184%
Multiplan Phcs Pediatric	$169	1184%
Usa Mco-All Plans	$169	1184%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $169.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hammond Henry Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.