CMS Price Transparency Data

Hepatitis C antibody test

Facility: Cleveland Clinic Avon Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $28
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Cleveland Clinic Avon Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.96x the Medicare baseline. Located in 33300 Cleveland Clinic Blvd, Avon, OH.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $60 (420%)
Insurance Median: $28 (196%)
Cash: $60 (420% of Medicare)
Ins. Median: $28 (196% 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.

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 - $93 98%
Devoted Health $14 98%
Humana $14 98%
Mmo $14 - $28 98%
Summacare $14 - $37 98%
The Health Plan $14 - $56 98%
United $14 - $21 98%
UnitedHealthcare $14 - $58 98%
Upmc $14 - $56 98%
Valor $14 98%
Cigna $15 - $26 105%
Communicare $15 105%
Perennial Health $15 105%
Cc Ehp $16 - $37 112%
Blue Cross Blue Shield $19 - $60 133%
Buckeye $19 133%
Molina $19 133%
Caresource $20 140%
Oscar $28 - $36 196%
Zing Health $28 196%
Aultcare $40 280%
Amish Community Aid Plan $42 - $46 294%
Ohcp $45 315%
Omas $46 322%
Ohio Healthy $50 350%
Php $56 392%
Gms $65 456%
Medical Benefit Corp $65 456%
Consociate Health $70 491%
Frontpath $84 589%
Managed Care Services $84 589%
Multiplan $84 589%
Tertiary Care Network $84 589%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 33300 Cleveland Clinic Blvd, Avon, OH 44011
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals