CMS Price Transparency Data

Hepatitis C antibody test

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $24
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Essentia Health St Joseph's Medical Center is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.68x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $62 (434%)
Insurance Median: $24 (168%)
Cash: $62 (434% of Medicare)
Ins. Median: $24 (168% 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
Medica Access $10 - $48 70%
Advocare/Security Health $14 98%
Blue Cross Blue Shield $14 - $107 98%
Blue Plus Pmap Pcc Prime $14 - $97 98%
Freedom Blue Ppo $14 98%
Healthpartners Care Msho / Mcr Adv $14 98%
Healthpartners Care Pmap $14 - $66 98%
Imcare Msho Pcc Prime $14 98%
Imcare Msho Ref Req $14 98%
Itasca Med Care $14 98%
Medica Advantage Solutions $14 98%
Medica Msho/Dual Solutions $14 98%
Medica Prime Solution Group $14 98%
Medicare (plans) $14 98%
Nd Va Administration $14 98%
Platinum Blue/Vantage Blue $14 98%
Primewest $14 98%
Primewest Msho $14 98%
Sanford Health Plan $14 - $69 98%
Secure Blue Msho $14 98%
Ubh Cost Plan $14 98%
Ubh Msho $14 98%
Ucare Msho $14 98%
UnitedHealthcare $14 - $116 98%
Medica $20 - $108 140%
Medica Uplan $20 - $97 140%
Ucare $21 - $101 147%
Medica Choice $23 - $111 161%
Wea $23 - $118 161%
Cigna $24 - $112 168%
Healthpartners $24 - $112 168%
Healthpartners Pcc Prime $24 - $112 168%
America'S Ppo $25 - $119 175%
Aetna $27 - $130 189%
Wps $27 - $129 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals