CMS Price Transparency Data

Hepatitis C antibody test

Facility: Cache Valley Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $16
Cash Discount Price: $198
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Cache Valley Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.12x the Medicare baseline. Located in 2380 North 400 East, North Logan, UT.

Cash / Self-Pay

$198

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $198 (1388%)

Insurance Median: $16 (112%)

Cash: $198 (1388% of Medicare)

Ins. Median: $16 (112% 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.

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
Molina Healthcare	$12 - $14	84%
Cigna	$13 - $17	91%
Coventry Altius	$14	98%
Health Choice	$14	98%
Humana	$14	98%
Regence	$14 - $16	98%
University Of Ut	$14	98%
Veteran'S Administration	$14	98%
Bright Health	$29	203%
Pehp	$46 - $57	322%
Aetna	$65 - $108	456%

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 $198.
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 Cache Valley 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.