CMS Price Transparency Data

Hepatitis C antibody test

Facility: Providence St Peter Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $20
Cash Discount Price: $131
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Providence St Peter Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.40x the Medicare baseline. Located in 413 Lilly Road Ne, Olympia, WA.

Cash / Self-Pay

$131

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: $131 (918%)

Insurance Median: $20 (140%)

Cash: $131 (918% 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.

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
UnitedHealthcare	$12 - $17	84%
Kaiser	$14 - $45	98%
Aetna	$15 - $74	105%
Blue Shield	$15	105%
Humana	$16	112%
Community Health Plan	$23	161%
Molina	$24	168%
Blue Cross Blue Shield	$26	182%
Coordinated Care	$26	182%
Cigna	$32	224%
Providence Health Plan	$47	329%
First Choice	$80	561%

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 $131.
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 Providence St Peter 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.