CMS Price Transparency Data

Hepatitis C antibody test

Facility: PAM Rehabilitation Hospital of Fargo

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $184
  • Cash Discount Price: $254
  • vs. Medicare Baseline: 12.89x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at PAM Rehabilitation Hospital of Fargo is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 12.89x the Medicare baseline. Located in 4671 38Th St S, Fargo, ND.
Cash / Self-Pay
$254

Average discount available for prompt cash payment at this facility.

Insurance Median
$184

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: $254 (1780%)
Insurance Median: $184 (1289%)
Cash: $254 (1780% of Medicare)
Ins. Median: $184 (1289% 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 1289% of the Medicare baseline (a markup of 1189%). 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 $14 98%
Primewest Minnesota $14 98%
Ucare Of Minnesota $14 98%
Medica $54 - $108 378%
Sanford Health Plan $118 827%
Cigna $152 - $178 1065%
Ilumed Aco Reach $165 1156%
Americas Choice Provider Network $178 1247%
Provider Network Of America $190 1331%
Quik Trip $190 1331%
Usa Managed Care Organization $190 1331%
Velocity Provider Ppo Network $190 1331%
Multiplan/Phcs $203 1423%
Prime Health Services $216 1514%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4671 38Th St S, Fargo, ND 58104
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL