CMS Price Transparency Data

Hepatitis C antibody test

Facility: McKenzie-Willamette Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $30
Cash Discount Price: $126
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at McKenzie-Willamette Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.10x the Medicare baseline. Located in 1460 G Street, Springfield, OR.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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: $126 (883%)

Insurance Median: $30 (210%)

Cash: $126 (883% of Medicare)

Ins. Median: $30 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Pacificsource Hlthier Or	$11	77%
Pacificsource Mcaid	$11	77%
Trillium Mcaid-All Plans	$11	77%
Healthnet Mcd	$12	84%
Kaiser Mcr Adv	$14	98%
Healthnet Mcr Adv	$15	105%
UnitedHealthcare	$19	133%
Providence Hp Pebb	$29	203%
Pacificsource Individual	$30	210%
Pacificsource Non-Individ	$30	210%
Pacificsource Psn/Voyager - All Other Plans	$30	210%
Blue Cross Blue Shield	$42	294%
Kaiser Mcaid	$47	329%
Healthnet Comm - All Other Plans	$107	750%
Providence Hp - All Other Plans	$136	953%
Cigna	$145	1016%
Aetna	$168	1177%
Kaiser Comm - All Other Plans	$566	3966%

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 $126.
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 McKenzie-Willamette Medical Center 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.