CMS Price Transparency Data

Hepatitis C antibody test

Facility: University of Miami Hospital and Clinics

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $64
Cash Discount Price: $27
vs. Medicare Baseline: 4.48x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at University of Miami Hospital and Clinics is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.48x the Medicare baseline. Located in 1475 Nw 12Th Ave Suite 2175, Miami, FL.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $27 (189%)

Insurance Median: $64 (448%)

Cash: $27 (189% of Medicare)

Ins. Median: $64 (448% 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 448% of the Medicare baseline (a markup of 348%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Careplus	$6 - $145	42%
Sunshine Health	$6 - $145	42%
Amerihealth Caritas Fl	$7 - $163	49%
Molina Healthcare Of Fl	$7 - $157	49%
Oscar Health Of Fl	$7 - $163	49%
Blue Cross Blue Shield	$8 - $370	56%
Aetna	$9 - $319	63%
Cigna	$9 - $253	63%
Curative	$14 - $308	98%
UnitedHealthcare	$14 - $62	98%
Avmed	$15 - $378	105%
Employers Health Network	$16 - $349	112%
Humana	$16	112%
Simply Healthcare	$16 - $349	112%
Solis Health	$16	112%
First Health	$17 - $378	119%
Health First New York Health Insurance	$17 - $378	119%
Broward Health	$18 - $407	126%
Beech Street	$21 - $465	147%
Dimension Health	$21 - $465	147%
Multiplan	$21 - $465	147%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $27.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Miami Hospital and Clinics is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.