CMS Price Transparency Data

Hepatitis C antibody test

Facility: Lower Keys Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $9
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Lower Keys Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$9

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: $9 (63%)
Insurance Median: $14 (98%)
Cash: $9 (63% 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
Self Pay $4 - $17 28%
Simply Healthcare $5 - $15 35%
Blue Cross Blue Shield $6 - $47 42%
Florida Childrens Medical Services $8 56%
Medicaid / KanCare $8 - $9 56%
South Florida Community Care Network $8 56%
UnitedHealthcare $8 - $36 56%
Amerigroup $9 63%
Cigna $9 - $28 63%
Humana $9 - $14 63%
Molina $9 63%
Positive Healthcare $9 63%
Wellcare $9 63%
Wellcare Healthease $9 63%
Magellan $10 70%
Prestige Health Choice $10 70%
Aetna $11 - $33 77%
Monroe County $12 - $35 84%
Avmed Health Plan $13 - $40 91%
Evolutions Healthcare Systems $13 - $45 91%
Keys Energy $13 - $38 91%
Prime Health Ppo $13 - $38 91%
Tricare $13 - $14 91%
Medicare (plans) $14 98%
Node Non Par Hospice Agree $14 98%
Node United Behavioral Va Ccn $14 98%
Node Va $14 98%
Ultimate Health $14 98%
Veterans Eval Services $14 98%
Node Champva $15 105%
Correct Care Solutions $16 112%
Direct Healthcare $16 - $47 112%
Fl Work Comp $16 112%
Heritage Summit Work Comp Fl $16 112%
Prime Health Work Comp Fl $16 112%
Node Us Dept Of Labor $18 126%
State Auto Insurance Fl $29 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals