CMS Price Transparency Data

Hepatitis C antibody test

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $30
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Independence Health System Butler Memorial Hospita is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.10x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$95

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: $95 (666%)
Insurance Median: $30 (210%)
Cash: $95 (666% 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.

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
Martin'S Point - Usfhp $13 - $47 91%
Tricare $13 91%
Gateway $14 - $142 98%
Geisinger $14 - $135 98%
Highmark $14 - $30 98%
Jefferson Health Plan $14 98%
Life Butler County $14 98%
Medicare (plans) $14 98%
Peak Health $14 - $94 98%
Provider Partners $14 98%
UnitedHealthcare $14 - $19 98%
Upmc $14 - $142 98%
Aetna $15 - $108 105%
Amerihealth $15 - $21 105%
Devoted Health Plan $15 - $54 105%
Humana $15 105%
Pa Health & Wellness $15 105%
The Health Plan $15 - $34 105%
American Health Plan $16 112%
Pnoa $16 - $108 112%
Highmark Aca - Direct Blue $19 - $25 133%
Medicaid / KanCare $19 133%
Cigna $21 - $68 147%
Highmark - Ind.& Managed Care $25 - $33 175%
Highmark Community Blue $25 - $30 175%
Ellwood Group $29 - $58 203%
Workers Comp $48 336%
Ccbh - Behavioral Health $68 - $72 477%
Private Healthcare Systems $94 - $115 659%
Devon $101 708%
Intergroup $108 757%
Multiplan $122 855%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals