CMS Price Transparency Data

Hepatitis C antibody test

Facility: Bay Area Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $119
Cash Discount Price: $102
vs. Medicare Baseline: 8.34x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Bay Area Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.34x the Medicare baseline. Located in 1775 Thompson Road, Coos Bay, OR.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $102 (715%)

Insurance Median: $119 (834%)

Cash: $102 (715% of Medicare)

Ins. Median: $119 (834% 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 834% of the Medicare baseline (a markup of 734%). 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
Southwest Oregon Ipa - All Plans	$12	84%
Healthnet Mcaid	$14	98%
Healthnet Mcr Adv	$15	105%
Moda Hlth Mcr Adv	$16	112%
Aetna	$19 - $20	133%
Moda Beacon - All Other Plans	$39	273%
Providence Pebb	$55	385%
Ods Ppo/Pos - All Plans	$56	392%
Nasomah Hlth Grp - All Plans	$80 - $84	561%
Pacificsource - All Plans	$113 - $119	792%
Moda Connexus/Synergy	$118 - $125	827%
First Choice - All Plans	$121 - $127	848%
Cigna	$122 - $129	855%
Providence - All Other Plans	$124 - $130	869%
Healthnet Comm- All Other Plans	$126 - $133	883%
UnitedHealthcare	$126 - $133	883%
Blue Cross Blue Shield	$476 - $501	3336%

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 $102.
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 Bay Area 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.