CMS Price Transparency Data

Hepatitis C antibody test

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $43
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 3.01x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Larkin Community Hospital Palm Springs Campus is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.01x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $120 (841%)
Insurance Median: $43 (301%)
Cash: $120 (841% of Medicare)
Ins. Median: $43 (301% 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 301% of the Medicare baseline (a markup of 201%). 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
Aetna $6 - $14 42%
Florida Community Care Mcaid-All Plans $6 42%
Miami Childrens Hp Mcaid-All Plans $6 42%
Simply Healthcare Mcaid $6 42%
Sunshine Mcaid $6 42%
United Mcaid $6 42%
Wellcare Mcaid $6 42%
Cigna $11 - $75 77%
Humana $13 - $299 91%
Ambetter / Centene $14 98%
Blue Cross Blue Shield $14 - $172 98%
Fdc - All Plans $14 98%
Medicare (plans) $14 - $299 98%
Opus Hospice Ip Only - All Plans $14 98%
Clear Springs Health - All Plans $15 105%
Unicare Simply Mcare Ppo - All Plans $15 105%
Bright Health Commercial - All Other Plans $17 119%
Ccs - All Plans $19 133%
Wellcare Comm (Choice) - All Other Plans $22 - $150 154%
Leon Med Center Mcr Adv - All Plans $39 - $269 273%
Careplus Health - All Other Plans $43 - $299 301%
Centurion Doc - All Plans $43 - $299 301%
Doctors Healthcare - All Plans $43 - $299 301%
Florida Health Solution/Hmo - All Plans $43 - $299 301%
Preferred Care Partners Mcr - All Plans $43 - $299 301%
Simply Healthcare Mcr - All Other Plans $43 - $299 301%
UnitedHealthcare $43 - $299 301%
Naphcare - All Plans $49 - $344 343%
Oscar Health-All Plans $86 - $598 603%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1475 W 49Th St, Hialeah, FL 33012
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals