CMS Price Transparency Data
Hepatitis C antibody test
Facility: Clovis Community Medical Center
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: $118
- vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Clovis Community Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$118
Average discount available for prompt cash payment at this facility.
Insurance Median
$14
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: $118 (827%)
Insurance Median: $14 (98%)
Cash: $118 (827% of Medicare)
Ins. Median: $14 (98% 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.
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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 |
|---|---|---|
| Genetically Handicapped Person | $13 | 91% |
| Chdp | $13 | 91% |
| Fresno County Funded Specialty Care | $13 | 91% |
| San Francisco Health Plan Medi-Cal | $13 | 91% |
| Ccs Kings | $13 | 91% |
| Medi-Cal Health Plan of San Mateo | $13 | 91% |
| Medi-Cal Community Health Group | $13 | 91% |
| Medi-Cal Contra Costa Health Plan | $13 | 91% |
| Medi-Cal Partnership Health Plan of Ca | $13 | 91% |
| Medi-Cal La Care Health | $13 | 91% |
| Medi-Cal Inland Empire Health | $13 | 91% |
| Ccs Mariposa | $13 | 91% |
| Ccs Merced | $13 | 91% |
| Gold Coast Medi-Cal | $13 | 91% |
| Ccs Tulare | $13 | 91% |
| Ccs Fresno | $13 | 91% |
| Santa Clara Family Health Plan - Valley Health | $13 | 91% |
| Medi-Cal Kern Family Health | $13 | 91% |
| Blue Shield | $13 - $84 | 91% |
| Blue Cross Blue Shield | $13 - $94 | 91% |
| Ccs Kern | $13 | 91% |
| Ccs Stanislaus | $13 | 91% |
| Cal Caloptima | $13 | 91% |
| Medi-Cal Molina | $13 | 91% |
| Medi-Cal California Health & Wellness Plan | $13 | 91% |
| Medi-Cal Alameda Alliance for Health | $13 | 91% |
| Medi-Cal Cencal Health | $13 | 91% |
| Ccs Madera/Sacramento | $13 | 91% |
| Generic Care Out of County | $13 | 91% |
| Santa Clara Family Health Plan - Premier Health | $13 | 91% |
| Medi-Cal Blue Shield Promise Health | $13 | 91% |
| Generic Ccs Other Counties | $13 | 91% |
| Meritage Blue Shield 65 Plus | $14 | 98% |
| Sequoia Pace - Peak Tpa | $14 | 98% |
| Healthnet HMO - Sante | $14 | 98% |
| Healthnet HMO - Cvmp/Medpro | $14 | 98% |
| Kaiser | $14 | 98% |
| Scan Health Plan | $14 | 98% |
| UnitedHealthcare | $14 - $77 | 98% |
| Brand New Day | $14 | 98% |
| Todays Pyramid | $14 | 98% |
| Sante Sub Cap-Blue Shield/Sante | $14 | 98% |
| Healthnet Sante - Sub Cap Dual Risk | $14 | 98% |
| Blue Shield Saint Agnes | $14 | 98% |
| Victims of Crime | $14 | 98% |
| Healthnet Sante Dual Risk | $14 | 98% |
| Bscphp - Dhmso | $14 | 98% |
| Aetna | $14 - $73 | 98% |
| Bscphp HMO - First Choice | $14 | 98% |
| Cigna | $14 - $91 | 98% |
| Sante-Healthnet Seniority | $14 | 98% |
| Generic Bscphp | $14 | 98% |
| Blue Shield 65 Plus HMO Ehs | $14 | 98% |
| Blue Shield Sante | $14 | 98% |
| Meritage Healthnet HMO | $14 | 98% |
| Wellcare | $14 | 98% |
| Healthnet HMO - Dhmso | $14 | 98% |
| Us Marshal | $14 | 98% |
| Care1St HMO - Ehs | $14 | 98% |
| Railroad Part A & B | $14 | 98% |
| Blue Shield 65 Plus HMO First Choice | $14 | 98% |
| Medi-Cal Innovative Integrated Health | $14 | 98% |
| Blue Shield Promise - Imperial | $14 | 98% |
| Railroad Part B | $14 | 98% |
| Meritage Brand New Day | $14 | 98% |
| Bscphp - First Choice | $14 | 98% |
| Hartford Life Supplement | $14 | 98% |
| Sante-Sub Cap Ma Brand New Day | $14 | 98% |
| Humana | $14 - $125 | 98% |
| Railroad Part A | $14 | 98% |
| Sante | $14 - $19 | 98% |
| Sante-Blue Shield/Sante | $14 | 98% |
| Cares Act Provider Relief Fund | $14 | 98% |
| Healthnet HMO - La Salle | $14 | 98% |
| Generic Victims of Crime | $14 | 98% |
| Medicare (plans) | $14 | 98% |
| Blue Shield Hmo-Cvmp/Medpro | $14 | 98% |
| Healthnet Sante | $14 | 98% |
| Gemcare HMO | $14 | 98% |
| Advantek Table Mountain Rancheria Tribal Member | $14 | 98% |
| Generic | $14 | 98% |
| Sante Sub Cap Healthnet Seniority | $14 | 98% |
| Imperial Health Plan HMO | $16 | 112% |
| Innovative Integrated Health Community Plans HMO | $16 | 112% |
| Champion Health Plan of California Ma | $16 | 112% |
| Alignment Health Plan | $16 | 112% |
| Health Plan of San Joaquin | $19 | 133% |
| Sequoia Pace | $19 | 133% |
| Correctcare Integrated Health | $19 | 133% |
| Adventist -McL Calviva Sub Cap | $21 | 147% |
| Healthnet | $24 - $87 | 168% |
| Coalinga State Hospital | $29 | 203% |
| Naphcare Inc-Mendota | $31 | 217% |
| Central Valley Medical Providers | $37 - $103 | 259% |
| Community Care | $38 | 266% |
| Employer 90/40 | $59 | 413% |
| Central Ca Indian Health | $81 | 568% |
| Nx Health Network PPO | $81 | 568% |
| Healthsmart | $100 - $118 | 701% |
| Network By Design | $111 | 778% |
| Coventry Health Care (First Health Network) | $111 | 778% |
| Generic Multiplan | $125 | 876% |
| PHCS | $125 | 876% |
| Well Path (Cfmg) | $162 | 1135% |