CMS Price Transparency Data

Hepatitis C antibody test

Facility: Indiana Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $20
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Indiana Regional Medical Center is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.40x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $47 (329%)
Insurance Median: $20 (140%)
Cash: $47 (329% of Medicare)
Ins. Median: $20 (140% 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.

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
Highmark $9 - $45 63%
Highmark Wholecare $10 - $15 70%
Tricare $13 - $131 91%
Aetna $14 - $44 98%
Cigna $14 - $45 98%
Humana $14 98%
Medicare (plans) $14 98%
United Mine Workers Of America $14 98%
UnitedHealthcare $14 - $52 98%
Ambetter / Centene $15 - $26 105%
Amerihealth Caritas $15 - $25 105%
Geisinger Health Plan $15 - $25 105%
Upmc Health Plan $15 - $126 105%
Geisinger $20 - $40 140%
Pa Health And Wellness Commercial $20 - $40 140%
Department Of Human Services And Torrance State Hospital $83 582%
Premier Comp Solutions, Llc $118 827%
Miscellaneous Commercial $131 918%
Pa Workers Compensation $131 918%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals