CMS Price Transparency Data

Hepatitis C antibody test

Facility: Fostoria Community Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $106
Cash Discount Price: $132
vs. Medicare Baseline: 7.43x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Fostoria Community Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 7.43x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $132 (925%)

Insurance Median: $106 (743%)

Cash: $132 (925% of Medicare)

Ins. Median: $106 (743% 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 743% of the Medicare baseline (a markup of 643%). 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
Meridian Health Plan Of Mi	$8	56%
Blue Cross Blue Shield	$14 - $132	98%
Buckeye Community Health Plan	$14 - $45	98%
Health Alliance Plan	$14 - $152	98%
Health Value Management	$14 - $44	98%
Paramount Health Care	$14 - $108	98%
Aetna	$16 - $136	112%
Buckeye Community Health Plan Inc	$16 - $74	112%
Dayton Area Health Plan Dba Caresource	$19 - $84	133%
UnitedHealthcare	$19 - $121	133%
Amerihealth	$36	252%
Veterans Affairs	$45	315%
Medical Mutual Of Ohio	$115 - $122	806%
Frontpath Health Coalition	$117	820%
Ohio Health Choice	$132	925%
Ohio Ppo Connect	$132 - $152	925%
Health Ohio Network	$160	1121%
Connecticut General Life Insurance Company	$162	1135%

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 $132.
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 Fostoria Community Hospital 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.