CMS Price Transparency Data

Hepatitis C antibody test

Facility: Gifford Medical Center

Billing Code: 86803 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$65
about 4.6× the $14 Medicare rate · typically $13–$70
modeled estimate · not a bill or quote
Medicare pays $14 Fair price $65 Cash price $78 Hospital's list price $155

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $14 - $147 98%
Blue Cross Blue Shieldmajor $69 - $132 484%
Aetnamajor $147 1030%
Cignamajor $124 869%
Harvard Pilgrim $124 869%
MVP Health Care $70 - $132 491%
+ 1 smaller / regional plan $70
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 44 South Main Street, Randolph, VT 05060
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals