CMS Price Transparency Data

Hepatitis C antibody test

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $151
Cash Discount Price: $248
vs. Medicare Baseline: 10.58x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 10.58x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$248

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $248 (1738%)

Insurance Median: $151 (1058%)

Cash: $248 (1738% of Medicare)

Ins. Median: $151 (1058% 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 1058% of the Medicare baseline (a markup of 958%). 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
Humana	$14 - $232	98%
Managed Health Services	$14 - $15	98%
Molina Healthcare Of Wi	$14 - $222	98%
Network Health Plan	$14 - $218	98%
Quartz	$14 - $149	98%
Security Health Plan (Shp)	$14 - $151	98%
UnitedHealthcare	$14 - $50	98%
Veteran'S Administration (Va Ccn)	$14	98%
Blue Cross Blue Shield	$15 - $75	105%
Group Health Cooperative Of Eau Claire	$15 - $248	105%
Icare	$15 - $16	105%
My Choice	$15	105%
Trilogy	$15 - $235	105%
The Alliance	$133	932%
Amish/Mennonite	$144	1009%
Wps Health Insurance	$176	1233%
Cigna	$177 - $193	1240%
Health Payment Systems	$182	1275%
First Health	$222	1556%
Healtheos By Multiplan Inc.	$243 - $248	1703%
Health Partners	$248	1738%
Coventry	$251	1759%

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 $248.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.