CMS Price Transparency Data

Hepatitis C antibody test

Facility: Towner County Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $119
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 8.34x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Towner County Medical Center is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.34x the Medicare baseline. Located in 228 1St Ave, Cando, ND.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

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: $132 (925%)
Insurance Median: $119 (834%)
Cash: $132 (925% of Medicare)
Ins. Median: $119 (834% 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 834% of the Medicare baseline (a markup of 734%). 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
Blue Cross Blue Shield $77 540%
Aetna $79 - $244 554%
UnitedHealthcare $79 - $119 554%
Medica $125 876%
Sanford Health Plan $125 876%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 228 1St Ave, Cando, ND 58324
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals