CMS Price Transparency Data

Hepatitis C antibody test

Facility: Adventist Health Portland

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $35
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Adventist Health Portland is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.45x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$37

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $37 (259%)
Insurance Median: $35 (245%)
Cash: $37 (259% of Medicare)
Ins. Median: $35 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Ods - All Plans $11 77%
Care Oregon - All Plans $12 84%
Kaiser Mcr Adv $14 98%
Humana $15 105%
Moda Mcr Adv $15 105%
UnitedHealthcare $15 - $176 105%
Healthnet Mcr Adv $16 112%
Aetna $17 119%
Healthnet Epo/Pos/Ppo $17 119%
Healthnet Hmo/Pos - All Other Plans $17 119%
Pacific Source Comm - All Plans $17 119%
Providence Hp - All Plans $17 119%
Ah Employee Health Plan - All Plans $26 182%
Healthcare Resources - All Plans $26 182%
Moda Conn Oebb/Syn Pebb $29 203%
Moda Affinity - All Other Plans $33 231%
Cigna $34 238%
Regence Ohsu Plus $35 245%
Kaiser - All Other Plans $37 259%
Regence - All Other Plans $39 273%
Workers Comp $40 280%
Moda Select $45 315%
Moda Connexus $51 357%
Moda Synergy $53 371%
Bc Premera First - All Plans $58 406%
Worldventure - All Plans $70 491%
Regence Preferred Mcr Adv $76 533%
First Choice - All Plans $81 568%
Multiplan - All Plans $88 617%
Phcs - All Plans $88 617%
Regence Mcr Adv $89 624%
First Health-Coventry - All Plans $94 659%
National Provider Network - All Plans $103 722%
Health Payors Organization Ltd- All Plans $105 736%
Moda Ohsu Ppo/Epo/Hmc $211 1479%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals