CMS Price Transparency Data

Hepatitis C antibody test

Facility: St Francis Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $95
  • Cash Discount Price: $276
  • vs. Medicare Baseline: 6.66x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St Francis Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $276. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.66x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$276

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $276 (1934%)
Insurance Median: $95 (666%)
Cash: $276 (1934% of Medicare)
Ins. Median: $95 (666% 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 666% of the Medicare baseline (a markup of 566%). 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
Blue Cross Blue Shield $14 - $211 98%
Blue Shield - De (Highmark) Medciare Advantage $14 98%
Cigna $14 - $263 98%
Highmark Health Options Dual Plan $14 98%
Pace-Trinity Health $14 98%
Saint Francis Life $14 98%
Aetna $15 - $276 105%
Medicare (plans) $15 105%
Coventry $17 119%
Delaware First Health $30 210%
Blue Benefit Administrators Of Massachusetts $95 666%
Blue Care Network $95 666%
Blue Distinction Transplant $95 666%
Blue Shield - Ca $95 666%
Blue Shield - Id (Regence) $95 666%
Blue Shield - Ny Highmark Northeastern $95 666%
Blue Shield - Ny Highmark Western $95 666%
Blue Shield - Pa (Highmark) $95 666%
Blue Shield - Wa (Regence) $95 666%
Medicaid / KanCare $149 1044%
Amerihealth $211 1479%
Meritain $276 1934%
Trustmark Small Business Benefits $276 1934%
Devon Health Services $404 2831%
Galaxy Health Network $404 2831%
Multiplan $404 2831%
Prime Health Services $404 2831%
Three Rivers Provider Network $404 2831%
Wc Corvel $404 2831%
Geha $408 2859%
UnitedHealthcare $408 2859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7Th and Clayton Sts, Wilmington, DE 19805
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals