CMS Price Transparency Data

Hepatitis C antibody test

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $191
Cash Discount Price: $98
vs. Medicare Baseline: 13.38x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Crystal Clinic Orthopaedic Center is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 13.38x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$191

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: $98 (687%)

Insurance Median: $191 (1338%)

Cash: $98 (687% of Medicare)

Ins. Median: $191 (1338% 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 1338% of the Medicare baseline (a markup of 1238%). 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
Bc Mcr Adv	$14	98%
Summacare Mcr Adv	$14	98%
UnitedHealthcare	$14 - $274	98%
The Health Plan - All Plans	$29	203%
Aultcare - All Plans	$42	294%
Health Oh Network - All Plans	$78	547%
Ohio Health Choice - All Plans	$78	547%
Med Mutual Nas	$81	568%
Multiplan - All Plans	$86	603%
Healthsmart - All Plans	$110	771%
Bc Pathway	$163	1142%
Cigna	$219	1535%
Bc Ohi/Ohii	$223	1563%
Summacare Comm - All Other Plans	$240	1682%
Med Mutual Medflex	$243	1703%
Bc Blue Access	$248	1738%
Bc Preferred	$248	1738%
Bc Trad - All Other Plans	$248	1738%
Med Mutual Aca	$277	1941%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$304	2130%
Aetna	$308	2158%

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 $98.
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 Crystal Clinic Orthopaedic Center 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.