CMS Price Transparency Data
Hepatitis C antibody test
Facility: Watsonville Community Hospital
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $28
- Cash Discount Price: $27
- vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Watsonville Community Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.96x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$27
Average discount available for prompt cash payment at this facility.
Insurance Median
$28
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: $27 (189%)
Insurance Median: $28 (196%)
Cash: $27 (189% of Medicare)
Ins. Median: $28 (196% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Pinnacle Claims Tpa/Bc | $2 - $92 | 14% |
| Western Health Advantage | $2 - $46 | 14% |
| Western Growers Trust/Bc | $2 - $92 | 14% |
| Health Net Pmg HMO | $3 - $58 | 21% |
| Great-West/Phcs | $3 - $64 | 21% |
| Pacificare HMO | $3 - $55 | 21% |
| Health Net Canopycare HMO | $3 - $58 | 21% |
| Health Net Blue and Gold | $3 - $58 | 21% |
| Health Net Smartcare Netw | $3 - $55 | 21% |
| UnitedHealthcare | $3 - $55 | 21% |
| Self Pay | $3 - $55 | 21% |
| Aetna | $3 - $75 | 21% |
| Pacificare PPO | $3 - $55 | 21% |
| Health Net of California | $3 - $58 | 21% |
| Cigna | $3 - $64 | 21% |
| Operating Engineers | $4 - $92 | 28% |
| Blue Cross Blue Shield | $4 - $92 | 28% |
| State Compensation Fund | $4 - $92 | 28% |
| Laborers Health & Welfare | $4 - $92 | 28% |
| Adventist Risk Management | $4 - $74 | 28% |
| Geha (Ccn) | $4 - $74 | 28% |
| Multiplan Inc PPO | $4 - $72 | 28% |
| Teamsters Benefit Trust | $4 - $92 | 28% |
| Calif Ironworkers Field | $4 - $92 | 28% |
| City of Wats/Pinnacle Clm | $4 - $92 | 28% |
| Transwestern | $4 - $74 | 28% |
| Salinas Valley Mem Hops | $4 - $78 | 28% |
| Claims Management Wc | $4 - $92 | 28% |
| First Health | $4 - $74 | 28% |
| Sheet Metal Workers | $4 - $92 | 28% |
| Coastal Healthcare Admin | $4 - $83 | 28% |
| Delta Health Systems | $4 - $92 | 28% |
| Carpenters H&W Trust | $4 - $92 | 28% |
| Private Healthcare System | $4 - $72 | 28% |
| Robert Kennedy/Ccn | $4 - $92 | 28% |
| Monterey Bay Pub Emp Trst | $4 - $92 | 28% |
| Farmers Insurance | $5 - $92 | 35% |
| Allstate | $5 - $92 | 35% |
| Bankers Life & Casualty | $5 - $92 | 35% |
| Victim Compensation Plan | $5 - $92 | 35% |
| Miscellaneous Auto | $5 - $92 | 35% |
| Prucare Pmg POS | $5 - $92 | 35% |
| Zenith National Ins | $5 - $92 | 35% |
| Apwu Health Plan | $5 - $92 | 35% |
| Wholesale Beer Distributo | $5 - $92 | 35% |
| Well Path | $5 - $92 | 35% |
| Prucare Pmg HMO | $5 - $92 | 35% |
| Aaa | $5 - $92 | 35% |
| Sutter Health Plus | $5 - $92 | 35% |
| United Administrative | $5 - $92 | 35% |
| State Farm Ins | $5 - $92 | 35% |
| Travelers Insurance | $5 - $92 | 35% |
| North Calif Bakery Driver | $5 - $92 | 35% |
| Humana | $5 - $92 | 35% |
| Aarp | $5 - $92 | 35% |
| Physicians Mutual | $5 - $92 | 35% |
| Miscellaneous Insurance | $5 - $92 | 35% |
| Medicruz | $8 - $17 | 56% |
| Secure Horizons Dign HMO | $9 - $18 | 63% |
| Blue Shield HMO | $9 - $18 | 63% |
| Nx Health Network | $14 | 98% |
| Western Growers Work Comp | $14 | 98% |
| Fleming & Associates | $14 | 98% |
| Hartford Workers' Comp | $14 | 98% |
| Secure Horizons | $14 | 98% |
| Blue Shield PPO | $14 - $45 | 98% |
| U.S. Dept. of Labor | $14 | 98% |
| Gallagher Bassett Svcs | $14 | 98% |
| Kemper Group Workers Comp | $14 | 98% |
| Crawford & Co | $14 | 98% |
| Keenan & Assoc Work Comp | $14 | 98% |
| Medicare (plans) | $14 | 98% |
| Fireman's Fund Work Comp | $14 | 98% |
| Alignment Health Plan | $14 | 98% |
| Miscellaneous Work Comp | $14 | 98% |
| Beta Healthcare Group | $14 | 98% |
| Veterans Administration | $14 | 98% |
| Workers Comp | $14 | 98% |
| Ace-Usa | $14 | 98% |
| Republic Idemnity W/Comp | $14 | 98% |
| Liberty Mutual Work Comp | $14 | 98% |
| Pinnacle Healthcare Uc | $14 | 98% |
| Tricare | $14 | 98% |
| Medi-Cal E.R. | $18 | 126% |
| California Childrens Srvs | $18 | 126% |
| Ccs/Monterey County | $18 | 126% |
| Medicaid / KanCare | $18 | 126% |
| Medi-Cal/Eds | $18 | 126% |
| Healthy Families | $18 - $45 | 126% |
| Alliance/Sccho | $19 | 133% |
| Ufcw/Valley Clerks | $45 | 315% |
| United Agriculture | $45 | 315% |
| Bs Employee | $45 | 315% |