CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mount Sinai Rehabilitation Hospital Inc

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $60
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mount Sinai Rehabilitation Hospital Inc is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.20x the Medicare baseline. Located in 490 Blue Hills Ave, Hartford, CT.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $58 (406%)
Insurance Median: $60 (420%)
Cash: $58 (406% of Medicare)
Ins. Median: $60 (420% 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 420% of the Medicare baseline (a markup of 320%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $14 - $19 98%
Blue Cross Blue Shield $14 - $60 98%
Cca Senior Care Options $14 98%
Cigna $14 - $19 98%
Geha $14 98%
Harvard Pilgrim Healthcare $14 98%
Medicare (plans) $14 - $15 98%
UnitedHealthcare $14 98%
1199 National Benefit Fund $19 133%
Allegiance $19 133%
Allied Benefit Systems $19 133%
Gravie Admin Services $19 133%
Hap $19 133%
Health Partners $19 133%
Luminare Health $19 133%
Magnacare $19 133%
Meritain $19 133%
Nippon Life Ins $19 133%
Webtpa $19 133%
Claimdoc $30 210%
Diversified Administrators $30 210%
Innovative Health Plan Ii $30 210%
Connecticut Dept Of Correction $46 322%
Health New England $56 392%
Bcn Domestic $60 420%
Blue Benefit Administrators Of Massachusetts $60 420%
Blue Care Network $60 420%
Blue Distinction Transplant $60 420%
Blue Shield - Ca $60 420%
Blue Shield - Id (Regence) $60 420%
Blue Shield - Ny Highmark Northeastern $60 420%
Blue Shield - Ny Highmark Western $60 420%
Blue Shield - Pa (Highmark) $60 420%
Blue Shield - Wa (Regence) $60 420%
Health Choices $60 420%
Kaiser Domestic $60 420%
Pre-Employment $60 420%
Unicare $60 420%
Wc Domestic $60 420%
Allied National Global Care $72 505%
Asrm - Reliance Standard Life Insurance $72 505%
Christian Care Ministry $72 505%
Dean Health $72 505%
Family Life Insurance Company $72 505%
Ghc Scw $72 505%
International Benefit Administrators $72 505%
Lifetime Benefit Solutions $72 505%
Manhattan Life $72 505%
Medi Share $72 505%
Multiplan $72 505%
Mvp $72 505%
Pai $72 505%
Pan-American Life $72 505%
Paramount Hmo $72 505%
Phcs $72 505%
Trinity Health Share $72 505%
Prime Health Services $85 596%
Connecticare $86 - $95 603%
Health Smart $90 631%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 490 Blue Hills Ave, Hartford, CT 06112
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL