CMS Price Transparency Data

Hepatitis C antibody test

Facility: Holland Community Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $22
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Holland Community Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.54x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $47 (329%)
Insurance Median: $22 (154%)
Cash: $47 (329% of Medicare)
Ins. Median: $22 (154% 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
Nomi Health - All Plans $11 77%
UnitedHealthcare $11 - $79 77%
Health Alliance Mcr Adv $14 98%
Life Circles-All Plans $14 98%
Ph Mcr Adv $14 98%
Va Ccn - All Plans $14 98%
Aetna $15 - $20 105%
Longevity Health Plan-All Plans $15 105%
Blue Cross Blue Shield $17 119%
Cofinity -All Plans $17 119%
Asr - All Plans $22 154%
Health Alliance Ahl - All Other Plans $22 154%
Health Alliance Hmo $22 154%
Sisco Epi $22 154%
Sisco-All Other Plans $22 154%
Cigna $23 161%
Molina Mcaid - All Plans $25 175%
Ph Mcaid $25 175%
Priority Health - All Other Plans $26 182%
Multiplan - All Plans $69 484%
Benefit Source Inc-All Plans $71 498%
First Health-All Plans $71 498%
Usa Managed Care-All Plans $71 498%
Integrated Health Plans-All Plans $75 526%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 602 Michigan Ave, Holland, MI 49423
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals