CMS Price Transparency Data

Hepatitis C antibody test

Facility: Central Florida Lake Monroe Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $15
  • Cash Discount Price: $48
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Central Florida Lake Monroe Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$48

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $48 (336%)
Insurance Median: $15 (105%)
Cash: $48 (336% of Medicare)
Ins. Median: $15 (105% 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
Avmed $1 - $45 7%
Aetna $2 - $27 14%
Florida Health Care Plan $2 - $34 14%
Molina Healthcare $2 - $29 14%
Sunshine State Health Plan $2 - $23 14%
United $2 - $41 14%
Plotkin Health $3 - $45 21%
Prime Health Sheriff $3 - $45 21%
Multiplan $4 - $77 28%
Three Rivers Provider Network $4 - $68 28%
Novanet $5 - $81 35%
Ppo Next $5 - $77 35%
Freedom Health $7 49%
Optimum $7 49%
Humana $13 - $57 91%
Devoted Health $14 98%
Ndms Definitive Care $14 98%
Simply $14 98%
Wellmed $14 98%
Align Senior Care $15 105%
American Health Plan $15 105%
Blue Cross Blue Shield $15 105%
Cigna $15 105%
Fl Health Care Plan $15 105%
Florida Complete Care $15 105%
Sunshine State $15 105%
Wellcare $15 105%
Careplus $16 112%
Centurion $16 112%
Clear Spring Health $16 112%
Gold Kidney Of Florida $16 112%
Seminole County Sheriffs Office $16 112%
Ultimate Health Plan $16 112%
Longevity Health Plan $17 119%
Evolutions $21 147%
Oscar $21 147%
Solis Health Plan $21 147%
Simply Healthcare $22 154%
Corvel Corporation $120 841%
Prime Health $123 862%
Careworks (Rockport Community) $127 890%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals