CMS Price Transparency Data
Hepatitis C antibody test
Facility: Claiborne Memorial Medical Center
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $60
- Cash Discount Price: $93
- vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Claiborne Memorial Medical Center is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.20x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$93
Average discount available for prompt cash payment at this facility.
Insurance Median
$60
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: $93 (652%)
Insurance Median: $60 (420%)
Cash: $93 (652% of Medicare)
Ins. Median: $60 (420% 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 420% of the Medicare baseline (a markup of 320%). 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.
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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 | $14 - $60 | 98% |
| Amerihealth Caritas La | $14 - $40 | 98% |
| Arcadian Community Mcr Hm | $14 | 98% |
| Blue Cross Blue Shield | $14 - $78 | 98% |
| Champus | $14 | 98% |
| Champva | $14 | 98% |
| Cigna | $14 - $70 | 98% |
| Community Health Solution | $14 - $40 | 98% |
| Correctcare Intergrated | $14 - $40 | 98% |
| Healthy Blue | $14 - $40 | 98% |
| Healthy Blue Dual Adv | $14 | 98% |
| Humana | $14 - $93 | 98% |
| Kaiser Foundation Health | $14 | 98% |
| Louisiana Hc Connections | $14 - $40 | 98% |
| Magellan Services | $14 - $40 | 98% |
| Medicaid / KanCare | $14 - $40 | 98% |
| Medicare (plans) | $14 | 98% |
| Peoples Health Network | $14 | 98% |
| Pyramid Claims Mcr Hmo | $14 | 98% |
| Sterling Connect 2 | $14 | 98% |
| Sterling Premier Mc Hmo | $14 | 98% |
| Superior Health Mcr Hmo | $14 | 98% |
| Tenet Mcr Hmo | $14 | 98% |
| Tricare | $14 | 98% |
| United Hc Mcr Hmo | $14 | 98% |
| UnitedHealthcare | $14 - $40 | 98% |
| Universal Hc Mcr Hmo | $14 | 98% |
| Us Dept Of Labor | $14 | 98% |
| Vantage Health Mcr Hmo | $14 | 98% |
| Windsor Sterling Mcr Hmo | $14 | 98% |
| Wps Mvh Vapc3 | $14 | 98% |
| All Savers | $18 | 126% |
| Golden Rule Ins Co | $18 | 126% |
| United Behavioral Health | $18 | 126% |
| Vantage Health Plan Inc | $19 | 133% |
| Ambetter / Centene | $20 | 140% |
| Commercial Insurance | $37 - $93 | 259% |
| Meritain Health | $37 - $60 | 259% |
| Coventry Healthcare | $56 | 392% |
| Geha | $65 | 456% |
| Health Plus Of La | $65 - $70 | 456% |
| Apwu Healthplan | $70 | 491% |
| Great West Healthcare | $70 | 491% |
| Phcs | $74 | 519% |
| Ppo Plus | $74 | 519% |
| Sedgwick Claims Mgmt Serv | $83 | 582% |
| Workman'S Comp | $83 | 582% |
| Aarp | $93 | 652% |
| Accordia National | $93 | 652% |
| Aflac | $93 | 652% |
| Alameda Alliance Forhealt | $93 | 652% |
| American Pioneer | $93 | 652% |
| Benefit Management | $93 | 652% |
| Benesys Inc | $93 | 652% |
| Business Guarantor | $93 | 652% |
| Chubb | $93 | 652% |
| Commercial Sr. Care | $93 | 652% |
| Employee Benefit Services | $93 | 652% |
| Family Life Insurance Co | $93 | 652% |
| Farm Bureau Insurance | $93 | 652% |
| Fiserv Health Benefit | $93 | 652% |
| Gmp | $93 | 652% |
| Group And Pension Admin | $93 | 652% |
| Group Resources | $93 | 652% |
| Haik Minvielle And Grubbs | $93 | 652% |
| Harrington Benefit Svs | $93 | 652% |
| Health Design Plus | $93 | 652% |
| Health Plan | $93 | 652% |
| Healthscope Benefits | $93 | 652% |
| Insurance Management Admi | $93 | 652% |
| Jefferson National | $93 | 652% |
| John Alden Health Ins | $93 | 652% |
| John Hancock | $93 | 652% |
| Liberty Mutual | $93 | 652% |
| Mailhandlers Benefit Plan | $93 | 652% |
| Manhattan Life Ins Co | $93 | 652% |
| Mega Life And Health | $93 | 652% |
| Msa Careguard | $93 | 652% |
| Mutual Of Omaha | $93 | 652% |
| Nalc Health Benefit Plan | $93 | 652% |
| Naphcare Inc. | $93 | 652% |
| New Era Life Ins Co | $93 | 652% |
| Physicians Mutual | $93 | 652% |
| Principal Financial Group | $93 | 652% |
| Prudential Healthcare | $93 | 652% |
| Self Pay | $93 | 652% |
| State Farm | $93 | 652% |
| State Farm Insurance | $93 | 652% |
| State Mutual Insurance Co | $93 | 652% |
| Sterling Investors Life | $93 | 652% |
| Tower Life | $93 | 652% |
| Transamerica Premier Ins | $93 | 652% |
| United American | $93 | 652% |
| United Comm Travelers | $93 | 652% |
| United Teachers | $93 | 652% |
| Usable Administrator | $93 | 652% |
| Visn 16 Cfu | $93 | 652% |
| Wausau Benefits | $93 | 652% |
| Webtpa | $93 | 652% |
| Wells Fargo | $93 | 652% |
| Woodmen Of The World | $93 | 652% |