CMS Price Transparency Data

Hepatitis C antibody test

Facility: New Ulm Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $36
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at New Ulm Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.52x the Medicare baseline. Located in 1324 Fifth North Street, New Ulm, MN.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $28 (196%)
Insurance Median: $36 (252%)
Cash: $28 (196% of Medicare)
Ins. Median: $36 (252% 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 252% of the Medicare baseline (a markup of 152%). 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.

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
Ucare Pmap (A B C D E G N O S U R H) $9 - $32 63%
Medica Health System $10 - $130 70%
Aetna $13 - $87 91%
Medicaid / KanCare $14 - $33 98%
Medicare (plans) $14 - $31 98%
Blue Cross Blue Shield $15 - $162 105%
Medica $15 - $124 105%
Hennepin Health $16 112%
UnitedHealthcare $18 - $97 126%
Medica Dual Solutions (A U) $19 - $71 133%
South Country Health Alliance $22 - $36 154%
Health Partners $26 - $44 182%
Americas Ppo (Araz)(A M U) $29 - $107 203%
Medica Ubh (A) $30 - $134 210%
Medica Ubh (N) $31 - $58 217%
Medica Mhps $33 - $124 231%
Americas Ppo (Araz)(B D N O R S V) $34 - $54 238%
Medica Ubh Pmap $35 - $128 245%
Cigna $36 - $57 252%
First Health (A C E G H U B D N O R S) $36 - $134 252%
Americas Ppo (Araz) (B D N H O R S) $37 - $58 259%
All Other Contracted Care (A B C D E G H N O R S U) $44 - $70 308%
Bc Aware/Blue Plus (Nr) $112 785%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1324 Fifth North Street, New Ulm, MN 56073
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals