CMS Price Transparency Data

Hepatitis C antibody test

Facility: Clinton Memorial Hospital

Billing Code: 86803 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$20

about 1.4× the $14 Medicare rate · typically $19–$20

modeled estimate · not a bill or quote

What this hospital charges insurers

$20

About the fair price

1.4× Medicare

Medicare pays $14 Fair price $20 This hospital $20 Cash price $54 Hospital's list price $108

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

Highest price of the 9 OH hospitals we have prices for — worth calling around.

Cheapest $13 Priciest $20

Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.

A fair price for a Hepatitis C antibody test is about $20 (about 1.4× the $14 Medicare rate). Clinton Memorial Hospital charges insurers about $20, or about $54 in cash — about the fair price. Located in Wilmington, OH.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

1 of 6 major insurers have a published price at this hospital

✓ Aetna UnitedHealthcareBlue Cross Blue ShieldCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Aetnamajor	$14 - $32	98%
CareSource	$19	133%
+ 1 smaller / regional plan	$15 - $21

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 54), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 86803.

Insurance Before you use insurance

Call your insurance company to confirm Clinton Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 86803.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Clinton Memorial Hospital

Compare: Hepatitis C antibody test at other OH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.