CMS Price Transparency Data

Hepatitis C antibody test

Facility: Medical Center Enterprise

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $262
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Medical Center Enterprise is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $262. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$262

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: $262 (1836%)
Insurance Median: $14 (98%)
Cash: $262 (1836% 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.

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
Medicaid / KanCare $5 - $10 35%
Bc Pml $11 77%
Node Champva $12 84%
Tricare $12 84%
UnitedHealthcare $13 - $14 91%
Aetna $14 - $940 98%
Blue Cross Blue Shield $14 98%
Covenant Hospice $14 98%
Dayspring Hospice $14 98%
Healthspring $14 98%
Humana $14 98%
Medicare (plans) $14 98%
Node Clover Mcr Adv $14 98%
Node Devoted Health Mcr Adv $14 98%
Node Hospice Non Par $14 98%
Node Va $14 98%
Occunet $14 98%
Select Health $14 98%
Southerncare Hospice $14 98%
Veterans Eval Services $14 98%
Wiregrass Hospice $14 98%
Eon Health $15 105%
Node Wellcare Mcr Adv $15 105%
Al Maternity Waiver Program $16 112%
Node Us Dept Of Labor $18 126%
Ambetter / Centene $21 147%
Cigna $25 - $131 175%
Self Pay $121 - $403 848%
American Employee Alliance $537 3763%
Alamed $806 5648%
Affordable Health $940 6587%
Health Choice $940 6587%
Novanet Ppo $940 6587%
Coventry Work Comp Al $988 6924%
Multiplan $994 - $1,061 6966%
Wc Dept Ind Relations $1,074 7526%
Corvel $1,142 8003%
Galaxy Health $1,209 8472%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals