CMS Price Transparency Data

Hepatitis C antibody test

Facility: Wheatland Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $153
Cash Discount Price: $161
vs. Medicare Baseline: 10.72x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Wheatland Memorial Hospital is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 10.72x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.

Cash / Self-Pay

$161

Average discount available for prompt cash payment at this facility.

Insurance Median

$153

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: $161 (1128%)

Insurance Median: $153 (1072%)

Cash: $161 (1128% of Medicare)

Ins. Median: $153 (1072% 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 1072% of the Medicare baseline (a markup of 972%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthnet Federal-All Plans	$98	687%
Humana	$98	687%
Medica Prime Solutions-All Plans	$98	687%
Pacific Source Mcr Adv	$98	687%
Triwest-All Plans	$98	687%
Amish Old Orders-All Plans	$121	848%
Allegiance Provider-All Plans	$137	960%
6 Degrees Health-All Plans	$153	1072%
Americas Choice-All Plans	$153	1072%
Community Health Ntwk-All Plans	$153	1072%
Fedmed Network-All Plans	$153	1072%
First Choice Big Sky-All Plans	$153	1072%
Interwest Ppo-All Plans	$153	1072%
Mountain Health Co-Op-All Plans	$153	1072%
Pacific Source-All Other Plans	$153	1072%
Pacific Steel & Recycling-All Plans	$153	1072%
Rocky Mountain Health Network-All Plans	$153	1072%
Three Rivers-All Plans	$153	1072%
First Health-All Plans	$155	1086%
Ccn-All Plans	$156	1093%
UnitedHealthcare	$158	1107%
City Of Billings-All Plans	$242	1696%

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 $161.
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 Wheatland Memorial 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.