CMS Price Transparency Data

Hepatitis C antibody test

Facility: Valley Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $41
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 2.87x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Valley Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.87x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $44 (308%)
Insurance Median: $41 (287%)
Cash: $44 (308% of Medicare)
Ins. Median: $41 (287% 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 287% of the Medicare baseline (a markup of 187%). 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
Regence Blue Shield [170100] $13 - $14 91%
Aetna $14 98%
Blue Cross Blue Shield $14 - $26 98%
Chpw Med Advantage [210102] $14 98%
Humana $14 - $15 98%
Medicare (plans) $14 - $15 98%
Premera Medadvantage [210114] $14 98%
Regence Hma [170105] $14 98%
Regence Hma1 [170102] $14 98%
Regence Medadvantage [210111] $14 98%
Regence Uniform [130111] $14 98%
UnitedHealthcare $14 - $41 98%
Wellpoint Medadvantage [210115] $14 98%
Bh United [180100] $17 119%
Chpw [130116] $23 161%
Molina [130117] $24 168%
Empire Plan [130124] $26 182%
Cigna $29 203%
Providence Health [130125] $29 203%
Benefit Md [150113] $41 287%
Carpenters Trust [150122] $41 287%
Cement Masons And Plasterers [150127] $41 287%
Coresource [150109] $41 287%
Employee Benefit Management Services [150108] $41 287%
Fc Moda Health [150139] $41 287%
First Choice Health Administrators [150110] $41 287%
First Choice Health Comp [150112] $41 287%
First Choice [150134] $41 287%
Health Net [150111] $41 287%
Here [150114] $41 287%
Hotel Employees Health Trust [150115] $41 287%
International Longshore & Warehouse Union [150116] $41 287%
Kitsap Physician Services [150118] $41 287%
Loomis Benefits West [150119] $41 287%
Mega [150120] $41 287%
Midwest [150121] $41 287%
Nw Administrators [150123] $41 287%
Operating Engineers [150125] $41 287%
Painters Trust [150126] $41 287%
Puget Sound Electric [150131] $41 287%
Seattle Plumb And Pipe [150132] $41 287%
Trusteed Plan [150101] $41 287%
United Employee Benefit Trust [150137] $41 287%
Washington Bakers Trust [150102] $41 287%
Washington Employers Trust [150103] $41 287%
Washington State Health Ins Pool [150104] $41 287%
Welfare Pension Administration Services [150105] $41 287%
Zenith Admin [150106] $41 287%
Zzjohn Alden [150117] $41 287%
Zzprincipal Financial Group [150128] $41 287%
Zzprovidence [150129] $41 287%
Kaiser Washington Contracted [130118] $52 364%
Kaiser Washington Non Contracted [140116] $52 364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S 43Rd St, Renton, WA 98055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals