CMS Price Transparency Data

Hepatitis C antibody test

Facility: Sanford Chamberlain Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $206
  • Cash Discount Price: $222
  • vs. Medicare Baseline: 14.44x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Sanford Chamberlain Medical Center is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 14.44x the Medicare baseline. Located in 300 S Byron, Chamberlain, SD.
Cash / Self-Pay
$222

Average discount available for prompt cash payment at this facility.

Insurance Median
$206

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: $222 (1556%)
Insurance Median: $206 (1444%)
Cash: $222 (1556% of Medicare)
Ins. Median: $206 (1444% 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 1444% of the Medicare baseline (a markup of 1344%). 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
Sanford Health Plan Align $95 666%
Ucare $102 - $243 715%
Wellmark Sd $102 - $241 715%
Aetna $103 - $241 722%
Health Partners $103 - $208 722%
Medicare (plans) $103 722%
UnitedHealthcare $103 - $231 722%
Primewest $105 736%
Sanford Health Plan $152 - $204 1065%
Security Health Plan $152 1065%
Medica $229 - $244 1605%
First Choice Health Network $249 1745%
Healthez $249 1745%
Multiplan $249 1745%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 S Byron, Chamberlain, SD 57325
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals