CMS Price Transparency Data

Hepatitis C antibody test

Facility: Adena Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $41
  • Cash Discount Price: $31
  • vs. Medicare Baseline: 2.87x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Adena Regional Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.87x the Medicare baseline. Located in 272 Hospital Road, Chillicothe, OH.
Cash / Self-Pay
$31

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $31 (217%)
Insurance Median: $41 (287%)
Cash: $31 (217% of Medicare)
Ins. Median: $41 (287% 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 287% of the Medicare baseline (a markup of 187%). 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
Aetna $14 - $104 98%
Buckeye Community Health Plan $14 98%
Humana $14 - $60 98%
Medical Mutual Of Ohio $14 - $41 98%
Medigold $14 98%
Molina $14 98%
UnitedHealthcare $14 - $35 98%
Care Source $15 105%
Gateway Health $15 105%
Molina Marketplace $24 168%
Care Source Just4Me $26 182%
Blue Cross Blue Shield $29 - $40 203%
Cigna $39 - $49 273%
Sidecar Health $39 273%
Ohio Ppo Connect $44 308%
The Health Plan $44 308%
First Health $49 - $103 343%
Ohio Health Choice $50 350%
Healthsmart $53 371%
Integrated Health Plan $60 420%
Multiplan/Private Healthcare Systems $60 420%
Three Rivers Network $60 420%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 272 Hospital Road, Chillicothe, OH 45601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals