CMS Price Transparency Data

Hepatitis C antibody test

Facility: North Shore Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $5
  • Cash Discount Price: $5
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at North Shore Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.35x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$5

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $5 (35%)
Insurance Median: $5 (35%)
Cash: $5 (35% of Medicare)
Ins. Median: $5 (35% 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
Cigna $2 - $5 14%
Humana $2 - $6 14%
Aetna $3 - $15 21%
Bc/Bs Of Fl Phs $3 21%
Dimensions International $3 21%
Magellan Behavioral Health $3 21%
Dimension Health Ppo $4 28%
First Health $4 28%
Veterans Administration Mill Bill $4 28%
Beacon Health Strategies Commercial $5 35%
Commercial Non-Contracted $5 35%
Devoted Health $5 35%
Employer Direct Healthcare $5 35%
Healthsun Health Plans $5 35%
Hospice Other $5 35%
Leon Health Inc $5 35%
Medicaid / KanCare $5 - $6 35%
Medicare (plans) $5 - $11 35%
Self Pay - Mcd Pending 100 Percent $5 35%
Single Case Agreement $5 35%
Tricare $5 35%
United Behavioral Health Psych $5 35%
UnitedHealthcare $5 - $13 35%
Veterans Administration Vaccn $5 35%
Bright Health Management Commercial $6 42%
Florida Pace Centers $6 42%
Longevity Health Plan $6 42%
Centurion Prison $7 49%
Self Pay/Uninsured $7 49%
Avmed Exchange $9 63%
Ambetter / Centene $10 70%
Molina Marketplace Program Exchange $10 70%
Amerihealth Caritas Next Exchange $11 77%
Auto Insurance $11 77%
Avmed Select Network $11 77%
Avmed Broad Network $12 84%
Dimension Health Wc $16 112%
Workers Compensation $16 112%
Imagine Health $17 119%
Oscar Health Plan Hix $17 119%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals