CMS Price Transparency Data

Hepatitis C antibody test

Facility: University Hospitals Avon Rehabilitation Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $66
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 4.63x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at University Hospitals Avon Rehabilitation Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.63x the Medicare baseline. Located in 37900 Chester Rd, Avon, OH.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $113 (792%)
Insurance Median: $66 (463%)
Cash: $113 (792% of Medicare)
Ins. Median: $66 (463% 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 463% of the Medicare baseline (a markup of 363%). 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
Uh Employees (Administered By Meritian) $26 - $62 182%
Blue Cross Blue Shield $38 - $160 266%
Healthsmart (Formerly Emerald) $43 - $104 301%
Ohio Health Choice - Preferred Choice Plus $43 - $104 301%
Clarity Health (Enterprise Group Planning Will Be Listed On Id Card As Well) $49 - $118 343%
Occunet Fka Health Ohio Network $49 - $118 343%
Paramount $50 - $160 350%
Ohio Preferred Network $53 - $128 371%
First Health $56 - $136 392%
Beechstreet $60 - $144 420%
Fortified $60 - $144 420%
Multiplan $60 - $144 420%
Ohio Health Choice $60 - $144 420%
Phcs $60 - $144 420%
Aetna $66 - $160 463%
Ambetter / Centene $66 - $160 463%
Amerihealth Cartias $66 - $160 463%
Antidote Healthe Care Of Ohio $66 - $160 463%
Aultcare $66 - $160 463%
Buckeye $66 - $160 463%
Caresource $66 - $160 463%
Caresource (Marketplace) $66 - $160 463%
Cigna $66 - $160 463%
Devoted $66 - $160 463%
Health Plan $66 - $160 463%
Humana $66 - $160 463%
Jp Farley (Select Employers) $66 - $160 463%
Medical Mutual $66 - $160 463%
Medical Mutual (Supermed, Trad, Medflex) $66 - $160 463%
Medical Mutual (Marketplace Plan) $66 - $160 463%
Molina $66 - $160 463%
Summacare $66 - $160 463%
United $66 - $160 463%
UnitedHealthcare $66 - $160 463%
Wellcare $66 - $160 463%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 37900 Chester Rd, Avon, OH 44011
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL