CMS Price Transparency Data

Hepatitis C antibody test

Facility: Ohio Valley Surgical Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $11,885
  • Cash Discount Price: $108
  • vs. Medicare Baseline: 832.87x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Ohio Valley Surgical Hospital is $11,885. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 832.87x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$108

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,885

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: $108 (757%)
Insurance Median: $11,885 (83287%)
Cash: $108 (757% of Medicare)
Ins. Median: $11,885 (83287% 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 83287% of the Medicare baseline (a markup of 83187%). 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 $2 - $40,293 14%
UnitedHealthcare $17 - $17,571 119%
Aetna $20 - $20,896 140%
Geha $20 - $20,896 140%
Genworth $20 - $20,896 140%
Mail Handlers $20 - $20,896 140%
Meritain $20 - $20,896 140%
Meritain Heatlh $20 - $20,896 140%
Mhbp $20 - $20,896 140%
Ngs Coresource $20 - $20,896 140%
Nippon Life $20 - $20,896 140%
Pacific Source $20 - $20,896 140%
Personify Health $20 - $20,896 140%
Mmoh $81 - $11,885 568%
Mmo Cin. Hmo $83 - $113 582%
Mmoh (Supermed) $83 - $84 582%
Medicare (plans) $108 - $12,264 757%
Luminare Health $162 1135%
Medben $162 1135%
Ohio Health $162 1135%
Preferred Health $162 1135%
Medicaid / KanCare $3,557 - $17,827 24926%
Amerihealth Caritas Of Ohio $3,657 25627%
Buckeye Community Health Plan $4,022 28185%
Molina Mcd $4,084 28619%
Caresource $4,364 - $17,827 30582%
Humana $4,493 - $11,919 31486%
Aarp $11,885 83287%
Aarp Supplemental $11,885 83287%
American Continental Insurance $11,885 83287%
American Continental Life $11,885 83287%
American Republic $11,885 83287%
American Retirement $11,885 83287%
Aultcare Primetime Health Plan $11,885 83287%
Bankers Fidelity $11,885 83287%
Bankers Life And Casualty $11,885 83287%
Central States $11,885 83287%
Champus $11,885 83287%
Cigna $11,885 - $18,817 83287%
Communicare Advantage $11,885 83287%
Everest $11,885 83287%
Gateway Health Plan $11,885 83287%
Medigold $11,885 83287%
Molina $11,885 83287%
Molina Dual Mcr $11,885 83287%
Molina Marketplace $11,885 83287%
Molina Dual Mcr $11,885 83287%
Molina Mcr $11,885 83287%
Molina Mcr Mcd $11,885 83287%
Molina Mcr+Mcd $11,885 83287%
Patient No Pay $11,885 83287%
Prosperity Supplement $11,885 83287%
Self Pay Imaging $11,885 83287%
Wellcare By Allwell $11,885 83287%
Wraparound Pl Supp $11,885 83287%
The Health Plan $12,479 87449%
Devoted Health $13,707 96055%
Employer Direct $15,703 110042%
Golden Rule $17,571 123132%
Medica $17,571 123132%
Oxford $17,571 123132%
Shl $17,571 123132%
Surest $17,571 123132%
Ushealth $17,571 123132%
Caresourse $17,827 124926%
Healthgram $18,817 131864%
Nalc $18,817 131864%
Samba $18,817 131864%
Sbma $18,817 131864%
Unified Group $18,817 131864%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals