CMS Price Transparency Data

Hepatitis C antibody test

Facility: Promedica Monroe Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $18
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Promedica Monroe Regional Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.26x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.
Cash / Self-Pay
$36

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: $36 (252%)
Insurance Median: $18 (126%)
Cash: $36 (252% 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 $8 - $14 56%
Blue Cross Blue Shield $8 - $31 56%
Meridian $8 56%
Molina Healthcare Of Michigan $8 56%
Priority Health $8 - $31 56%
UnitedHealthcare $8 - $45 56%
Health Alliance Plan $14 - $18 98%
Humana $14 98%
Paramount Healthcare Inc $14 - $43 98%
Veterans Affairs $14 98%
Amerihealth $16 112%
Frontpath $32 224%
Encore Health Network $39 273%
Health Ohio Network, Llc $39 273%
Cofinity $40 280%
Multiplan $50 350%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 718 N Macomb St, Monroe, MI 48162
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals