CMS Price Transparency Data

Hepatitis C antibody test

Facility: Hialeah Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Hialeah Hospital is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $62 (434%)
Insurance Median: $14 (98%)
Cash: $62 (434% of Medicare)
Ins. Median: $14 (98% 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
Aetna $2 - $45 14%
Humana $6 - $28 42%
Medicaid / KanCare $6 42%
UnitedHealthcare $6 - $14 42%
Cigna $7 - $18 49%
Bc/Bs Myblue Hmo Hix $8 56%
Bc/Bs Of Fl Health Options Hmo $8 56%
Bc/Bs Of Fl Simplyblue $8 56%
Bc/Bs Of Fl Blue Select Exchange Non Par $9 63%
Bc/Bs Of Fl Miami Dade Blue Select $9 63%
Bc/Bs Of Fl Network Blue $9 63%
Bc/Bs Of Fl Ppo $9 63%
Veterans Administration Mill Bill $10 70%
Avmed Broad Network $12 84%
Medicare (plans) $13 - $31 91%
Bristol Hospice- Miami Dade Llc $14 98%
Catholic Hospice $14 98%
Comprehensive Home Health Care Dba Opuscare Of South Florida $14 98%
Devoted Health $14 98%
Employer Direct Healthcare $14 - $18 98%
Hcr Manor Care Services Of Fl $14 98%
Hospice Other $14 98%
Leon Health Inc $14 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $14 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $14 98%
Tricare $14 98%
Veterans Administration Vaccn $14 98%
Vitas Healthcare Hospice Corporation Of Fl $14 98%
Vitas Hospice Unit Agreement $14 98%
Healthsun Health Plans $15 105%
Longevity Health Plan $15 105%
Dimension Health Wc $16 112%
Workers Compensation $16 112%
Bright Health Management Commercial $17 119%
Florida Pace Centers $17 119%
Imagine Health $17 119%
Oscar Health Plan Hix $17 119%
Self Pay/Uninsured $17 119%
Naphcare Inc $20 140%
Avmed Exchange $25 175%
Ambetter / Centene $26 182%
Molina Marketplace Program Exchange $27 189%
Auto Insurance $29 203%
Avmed Select Network $29 203%
Amerihealth Caritas Next Exchange $31 217%
Bc/Bs Of Fl Phs $32 224%
Dimensions International $40 280%
First Health $42 294%
Dimension Health Ppo $47 329%
Commercial Non-Contracted $62 434%
Self Pay - Mcd Pending 100 Percent $62 434%
Single Case Agreement $62 434%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals