CMS Price Transparency Data

Hepatitis C antibody test

Facility: Bellin Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $47
Cash Discount Price: $51
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Bellin Memorial Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.29x the Medicare baseline. Located in 744 S Webster Ave, Green Bay, WI.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $51 (357%)

Insurance Median: $47 (329%)

Cash: $51 (357% of Medicare)

Ins. Median: $47 (329% 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 329% of the Medicare baseline (a markup of 229%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$14 - $59	98%
Community Care	$14 - $44	98%
Humana	$14 - $44	98%
My Choice	$14 - $20	98%
UnitedHealthcare	$14 - $55	98%
Aetna	$15 - $24	105%
Network Health	$15 - $59	105%
Chorus Community Health Plan	$38 - $92	266%
Aspirus Arise	$41 - $57	287%
Cigna	$42 - $56	294%
Wps Insurance	$43 - $67	301%
Hps/Paymedix	$44 - $63	308%
Trilogy	$45 - $60	315%
Healthsmart	$47 - $63	329%
Ihs(Claimsbridge)	$47 - $63	329%
Medical College Of Wi	$47 - $63	329%
Multiplan	$47 - $63	329%
Allied National	$50 - $67	350%
First Health	$50 - $67	350%
Galaxy Health	$50 - $67	350%
Three Rivers Provider Network	$53 - $71	371%
Common Ground	$89	624%

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 $51.
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 Bellin Memorial 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.