CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Florida Twin Cities Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $121
  • Cash Discount Price: $923
  • vs. Medicare Baseline: 8.48x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Florida Twin Cities Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $923. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.48x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.
Cash / Self-Pay
$923

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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: $923 (6468%)
Insurance Median: $121 (848%)
Cash: $923 (6468% of Medicare)
Ins. Median: $121 (848% 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 848% of the Medicare baseline (a markup of 748%). 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
Humana $13 - $351 91%
Ndms Definitive Care $14 98%
Regency Hospice $14 98%
United $14 - $415 98%
Wellmed $14 98%
Aetna $15 - $277 105%
American Health Plan $15 105%
Blue Cross Blue Shield $15 105%
Florida Complete Care $15 105%
Healthspring Of Florida $15 105%
Sunshine State $15 105%
Wellcare $15 105%
Centurion $16 112%
Clear Spring Health $16 112%
Gold Kidney Of Florida $16 112%
Ultimate Health Plan $16 112%
Longevity Health Plan $17 119%
Oscar $19 133%
Simply Healthcare $22 154%
Corvel Corporation $121 848%
Prime Health $124 869%
Careworks (Rockport Community) $128 897%
Simply $142 995%
Molina Healthcare $175 - $295 1226%
Avmed $222 - $462 1556%
Sunshine State Health Plan $235 1647%
Plotkin Health $462 3238%
Prime Health Sheriff $462 3238%
Evolutions Healthcare $600 - $785 4205%
Multiplan $720 - $785 5046%
Ppo Next $785 5501%
Novanet $831 5823%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2190 Hwy 85 N, Niceville, FL 32578
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals