CMS Price Transparency Data

Hepatitis C antibody test

Facility: St Joseph Health System, LLC

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $18
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St Joseph Health System, LLC is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.26x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$12

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: $12 (84%)
Insurance Median: $18 (126%)
Cash: $12 (84% 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
Aetna $2 - $305 14%
Blue Cross Blue Shield $2 - $163 14%
Cigna $2 - $449 14%
Lutheran Network $2 - $247 14%
Lutheran Preferred $2 - $269 14%
Php $2 - $179 14%
Three Rivers $2 - $202 14%
UnitedHealthcare $2 - $224 14%
Amish Aid $3 - $108 21%
Encore Ppo $3 - $404 21%
Multiplan $3 - $350 21%
Sagamore $3 - $243 21%
Self Pay $3 - $247 21%
Advantage Health Solutions $4 - $373 28%
Align Network $4 - $359 28%
Allied Benefit Systems $4 - $404 28%
First Health $4 - $337 28%
Frontpath Health Coalition $4 - $359 28%
Prime Health Services $4 - $337 28%
Tricare $4 - $13 28%
Department Of Veterans Affairs $5 - $14 35%
Humana $5 - $14 35%
In Dept Of Correction $5 - $15 35%
Managed Health Services $5 - $29 35%
Medical Mutual Of Ohio $5 - $449 35%
Medicare (plans) $5 - $14 35%
Node Devoted Health Mcr Adv $5 - $14 35%
Node Hospice Non Par Agree $5 - $14 35%
Node Pphp Mcr Adv $5 - $15 35%
Node Va $5 - $14 35%
Parkview Healthplan Services $5 - $449 35%
Php Freedom Network $5 - $26 35%
Value Options $5 - $449 35%
Veterans Eval Services $5 - $14 35%
Us Department Of Labor $6 - $18 42%
Lutheran Advanced Network $8 - $21 56%
Encore Work Comp In $9 - $26 63%
Work Comp $10 - $29 70%
Encore Kba Epo $12 - $34 84%
Caresource $14 98%
Medicaid / KanCare $14 98%
Encore Kba Ppo $15 - $43 105%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals