CMS Price Transparency Data

Hepatitis C antibody test

Facility: Connecticut Childrens Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $45
Cash Discount Price: $36
vs. Medicare Baseline: 3.15x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Connecticut Childrens Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.15x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $36 (252%)

Insurance Median: $45 (315%)

Cash: $36 (252% of Medicare)

Ins. Median: $45 (315% 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 315% of the Medicare baseline (a markup of 215%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$17 - $50	119%
Golden Rule [100106]	$17 - $50	119%
Harvard Pilgrim [1001134]	$17 - $50	119%
Oxford [100103]	$17 - $50	119%
UnitedHealthcare	$17 - $50	119%
1199 National Benefit Fund [100134]	$19 - $50	133%
Blue Cross Blue Shield	$19 - $45	133%
Connecticare [100105]	$19 - $32	133%
Emblem Health Commercial [1001108]	$19 - $32	133%
Government Employees Hospital Assoc [100115]	$19 - $50	133%
Humana	$19 - $50	133%
Medicaid / KanCare	$19 - $32	133%
Meritain Health [100149]	$19 - $50	133%
Nippon Life Ins Co Of America [100112]	$19 - $50	133%
Yale Health Plan [100162]	$19 - $50	133%
Unicare [100148]	$27 - $45	189%
Wellpoint [100150]	$27 - $45	189%
Multiplan [1001126]	$44 - $51	308%
Cigna	$47 - $52	329%
Great West Healthcare [100107]	$47 - $52	329%
Health Partners [110229]	$47 - $52	329%
Mvp Health Plan [100144]	$47 - $52	329%
Tufts Health Plan [100114]	$47 - $52	329%
Cdphp/Comm [100199]	$51	357%
Generic Multiplan [1001130]	$51	357%
Ultrabenefits/Comm [100181]	$51	357%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $36.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Connecticut Childrens Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.