CMS Price Transparency Data

Hepatitis C antibody test

Facility: Charlevoix Area Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $20
Cash Discount Price: $21
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Charlevoix Area Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.40x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $21 (147%)

Insurance Median: $20 (140%)

Cash: $21 (147% of Medicare)

Ins. Median: $20 (140% 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.

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	$9 - $96	63%
Blue Care Network	$9 - $50	63%
Hap (Health Alliance Plan)	$9 - $85	63%
Mclaren Health Plan	$9 - $99	63%
Medicare (plans)	$9 - $50	63%
Michigan Amish Medical Board	$9 - $50	63%
Northern Michigan Mennonite Group	$9 - $50	63%
Priority Health	$9 - $106	63%
UnitedHealthcare	$9 - $92	63%
Blue Cross Blue Shield	$10 - $98	70%
Meridian	$10	70%
Molina	$10 - $54	70%
Hospice Of Michigan	$12 - $64	84%
Cigna	$15 - $106	105%
Asr Physicians Care Network	$16 - $85	112%
Employee Benefits Logistics	$16 - $85	112%
Enterprise Group Planning Employee Benefit Plan	$16 - $85	112%
First Health/Coventry Health/Community Care Network	$16 - $85	112%
Medical Cost Savings Solution	$16 - $85	112%
Provider Network Of America/Hma Group Health	$17 - $90	119%
Three Rivers Provider Network	$17 - $90	119%
Cofinity	$18 - $99	126%
Iba Health And Life Assurance Company	$18 - $98	126%
Nomi Health	$18 - $99	126%
Preferred Medical Claim Solutions	$19 - $101	133%

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 $21.
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 Charlevoix Area 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.