CMS Price Transparency Data

Hepatitis C antibody test

Facility: Coral Gables Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $15
  • Cash Discount Price: $242
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Coral Gables Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $242. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
$242

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: $242 (1696%)
Insurance Median: $15 (105%)
Cash: $242 (1696% 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
Humana $6 - $88 42%
Medicaid / KanCare $6 42%
UnitedHealthcare $6 - $14 42%
Aetna $7 - $181 49%
Cigna $7 - $71 49%
Veterans Administration Mill Bill $10 70%
Avmed Broad Network $13 91%
Medicare (plans) $13 - $31 91%
Catholic Hospice $14 98%
Devoted Health $14 98%
Employer Direct Healthcare $14 - $18 98%
Hcr Manor Care Services Of Fl Ii Dba Heartland Hospice Services $14 98%
Hospice Other $14 98%
Leon Health Inc $14 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $14 98%
Opus Care Of South Florida $14 98%
Seasons Hospice And Palliative Care Of Southern Florida Inc $14 98%
Tricare $14 98%
Veterans Administration Vaccn $14 98%
Vitas Healthcare Corporation/Hospice Ppo $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%
Bc/Bs Myblue Hmo Hix $30 210%
Amerihealth Caritas Next Exchange $31 217%
Bc/Bs Of Fl Network Blue $32 224%
Bc/Bs Of Fl Ppo $32 224%
Bc/Bs Of Fl Simplyblue $32 224%
Bc/Bs Of Fl Blue Select Exchange Non Par $35 245%
Bc/Bs Of Fl Health Options Hmo $37 259%
Bc/Bs Of Fl Miami Dade Blue Select $37 259%
Bc/Bs Of Fl Phs $130 911%
Dimension International $157 1100%
First Health $172 1205%
Dimension Health Ppo $181 1268%
Commercial Non-Contracted $242 1696%
Self Pay - Mcd Pending 100 Percent $242 1696%
Single Case Agreement $242 1696%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Douglas Rd, Coral Gables, FL 33134
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals