CMS Price Transparency Data

Hepatitis C antibody test

Facility: Baldwin Health

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $21
  • Cash Discount Price: $211
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Baldwin Health is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.47x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$211

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $211 (1479%)
Insurance Median: $21 (147%)
Cash: $211 (1479% of Medicare)
Ins. Median: $21 (147% 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
First Choice $8 56%
Medicaid / KanCare $10 70%
Bc Pml $11 77%
Node Champva $12 84%
Tricare $12 84%
UnitedHealthcare $13 - $14 91%
Aetna $14 - $792 98%
Blue Cross Blue Shield $14 98%
Cigna $14 - $59 98%
Community Hospice $14 98%
Hospice $14 98%
Humana $14 98%
Medicare (plans) $14 98%
Mercy Medical Hospice $14 98%
Node Clover Health Mcr Adv $14 98%
Node Devoted Health Mcr Adv $14 98%
Node Va $14 98%
Select Health $14 98%
Triwest $14 98%
Veterans Eval Services $14 98%
Windsor Health Plan $14 98%
Node Wellcare Mcr Adv $15 105%
Us Dol $18 126%
Ambetter / Centene $21 147%
Self Pay $158 - $264 1107%
American Employee Alliance $352 2467%
Multiplan $501 - $721 3511%
First Health $660 - $710 4625%
Alamed $673 4716%
Multiplan Inc $673 4716%
Coventry Work Comp Al $688 4821%
One Health $704 4933%
Pro America $704 4933%
Novanet $710 4975%
Alabama Wc $748 5242%
Gulf Health $748 5242%
Principal Ppo $748 5242%
Viva Health $748 5242%
National Health $792 5550%
Galaxy $801 5613%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals