CMS Price Transparency Data

Hepatitis C antibody test

Facility: Nemours Children's Hospital, Delaware

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $24
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Nemours Children's Hospital, Delaware is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.68x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $40 (280%)
Insurance Median: $24 (168%)
Cash: $40 (280% of Medicare)
Ins. Median: $24 (168% 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
Keystone First Hlth Plan $5 - $39 35%
Amerihealth Caritas Delaware $8 - $50 56%
Blue Cross Blue Shield $9 - $78 63%
Celtic Transplant For De First Health $9 - $31 63%
Delaware First Health $9 - $32 63%
Kidz Partners $9 - $33 63%
UnitedHealthcare $9 - $55 63%
Wellpoint Maryland $9 - $33 63%
Fidelis $10 - $35 70%
Health Partners $10 - $34 70%
Upmc $10 - $35 70%
Aetna $11 - $51 77%
Priority Partners John Hopkins $12 - $43 84%
Six Degrees Health Transplant $12 - $44 84%
Ambetter / Centene $14 - $50 98%
Carefirst Md Community Health Plan $14 98%
Cigna $14 - $55 98%
Great West-One Health Plan $14 - $55 98%
Geisinger Health Plan $15 - $53 105%
Integra Administrative Group $15 - $53 105%
Tricare $15 105%
National Transplant Network (Ntn) $16 - $57 112%
Six Degrees Health $16 - $57 112%
Star Healthcare Network $16 - $57 112%
Us Family Health Plan $17 119%
Life Trac Solid Organ And Bmt Transplant $18 - $62 126%
Celtic Transplant $24 - $88 168%
First Health Network $24 - $84 168%
Insurance Administrators Of America $24 - $84 168%
Interlink Transplant Network $24 - $84 168%
Multiplan $24 - $84 168%
Preferred Healthcare $24 - $84 168%
Private Healthcare Systems $24 - $84 168%
Three Rivers Provider Network $24 - $84 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens