CMS Price Transparency Data

Hepatitis C antibody test

Facility: Medstar Washington Hospital Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $45
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 3.15x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Medstar Washington Hospital Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.15x the Medicare baseline. Located in 110 Irving Street Nw, Washington, DC.
Cash / Self-Pay
$100

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: $100 (701%)
Insurance Median: $45 (315%)
Cash: $100 (701% 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.

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
Carefirst Advantage Inc $14 98%
Tricare $14 98%
UnitedHealthcare $14 - $45 98%
Aetna $15 - $106 105%
Health Care Service Corporation $15 105%
Humana $15 105%
Kaiser Permanente $15 - $77 105%
Amerigroup $20 140%
Amerihealth Caritas District Of Columbia $20 140%
Hscsn $20 140%
Medstar Family Choice Inc $20 - $74 140%
Mamsi $21 147%
Cigna $92 645%
Pfc $100 701%
Ncppo Healthlink Ppo $115 806%
Private Healthcare Systems (Phcs) $123 862%
First Health $131 918%
Carefirst Blue Choice Inc $149 1044%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Irving Street Nw, Washington, DC 20010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals