CMS Price Transparency Data

Hepatitis C antibody test

Facility: Southern Coos Hospital & Health Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $67
Cash Discount Price: $151
vs. Medicare Baseline: 4.70x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Southern Coos Hospital & Health Center is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.70x the Medicare baseline. Located in 900 11Th Street Se, Bandon, OR.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $151 (1058%)

Insurance Median: $67 (470%)

Cash: $151 (1058% of Medicare)

Ins. Median: $67 (470% 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 470% of the Medicare baseline (a markup of 370%). 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
Healthnet - All Plans	$10 - $33	70%
Tricare	$41 - $135	287%
Advanced Health - All Plans	$44 - $146	308%
Aetna	$46 - $209	322%
Atrio Mcr Adv - Allplans	$46 - $153	322%
Confederated Tribes - All Plans	$46 - $153	322%
Moda Mcr Adv	$46 - $153	322%
Pacific Source Mcr Adv	$46 - $153	322%
Cigna	$56 - $183	392%
Moda Health Plan - All Other Plans	$63 - $206	441%
Prov Netwrk Of America - All Plans	$63 - $209	441%
Three Rivers - All Plans	$63 - $209	441%
UnitedHealthcare	$63 - $209	441%
Blue Cross Blue Shield	$65 - $216	456%
First Choice - All Plans	$65 - $213	456%
Multiplan - All Plans	$65 - $216	456%
First Health - All Plans	$67 - $220	470%
Pacific Source - All Other Plans	$67 - $220	470%
Providence Preferred - All Plans	$67 - $220	470%

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 $151.
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 Southern Coos Hospital & Health 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.