CMS Price Transparency Data

Hepatitis C antibody test

Facility: Rainbow Babies and Childrens Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $97
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 6.80x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Rainbow Babies and Childrens Hospital is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.80x the Medicare baseline. Located in 11100 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $116 (813%)
Insurance Median: $97 (680%)
Cash: $116 (813% of Medicare)
Ins. Median: $97 (680% 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 680% of the Medicare baseline (a markup of 580%). 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 $6 - $100 42%
Aetna $14 - $122 98%
Cigna $14 - $99 98%
Devoted Health $14 98%
Humana $14 98%
Medical Mutual Of Ohio $14 - $122 98%
Molina $14 98%
Primetime Health Plan $14 98%
Summacare $14 - $112 98%
The Health Plan $14 - $108 98%
UnitedHealthcare $14 - $108 98%
Wellcare By Allwell $14 98%
Paramount $15 105%
Perennial Advantage Of Ohio $15 105%
Valor Health Plans $15 105%
University Health Employee Plan (Contigo) $20 - $77 140%
Amish Aid Community Plan $77 540%
Amish Church Fund And Workers Aid Plan $77 540%
Buckeye Plain Ministries $77 540%
Christian Healthcare Ministries $77 540%
Sunrise Plain Communities $77 540%
Caresource $83 582%
Ambetter / Centene $86 603%
Jp Farley $86 - $92 603%
Immergrun $92 645%
Aultcare $97 - $102 680%
Healthsmart $100 701%
Ohio Health Choice $100 - $139 701%
Health Ohio Network $103 722%
Clarity $108 757%
Enterprise Group Planning $108 757%
Medical Mutual Traditional/Health Ohio $108 757%
Beech Street $123 - $139 862%
Ohio Preferred Network $123 - $139 862%
Century Health Network $131 918%
First Health $131 918%
Private Healthcare System $132 925%
Configurenet $139 974%
Fortified Provider Network $139 974%
Multiplan $139 974%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11100 Euclid Avenue, Cleveland, OH 44106
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens