CMS Price Transparency Data

Hepatitis C antibody test

Facility: Palmetto General Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $16
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Palmetto General Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.12x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $119 (834%)
Insurance Median: $16 (112%)
Cash: $119 (834% of Medicare)
Ins. Median: $16 (112% 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
Aetna $4 - $84 28%
Humana $6 - $48 42%
Medicaid / KanCare $6 - $119 42%
UnitedHealthcare $6 - $14 42%
Cigna $7 - $59 49%
Veterans Administration Mill Bill $10 70%
Avmed Broad Network $13 91%
Medicare (plans) $13 - $119 91%
Bristol Hospice- Miami Dade Llc $14 98%
Catholic Hospice $14 98%
Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc $14 98%
Devoted Health $14 98%
Employer Direct Healthcare $14 - $18 98%
Hospice Other $14 98%
Ima Evalutations Inc $14 98%
Leon Health Inc $14 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $14 98%
Opuscare Of South Fl $14 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $14 98%
Select Specialty Hospital $14 98%
Tricare $14 98%
Veterans Administration Vaccn $14 98%
Vitas Healthcare Hospice $14 98%
Westchester General Hospital $14 98%
Healthsun Health Plans $15 105%
Longevity Health Plan $15 105%
Dimension Health Wc $16 112%
Workers Compensation $16 112%
Bc/Bs Myblue Hmo Hix $17 119%
Bc/Bs Of Fl Network Blue $17 119%
Bc/Bs Of Fl Simplyblue $17 119%
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%
Bc/Bs Of Fl Blue Select Exchange Non Par $18 126%
Bc/Bs Of Fl Health Options Hmo $18 126%
Bc/Bs Of Fl Ppo $18 126%
Naphcare Inc $20 140%
Bc/Bs Of Fl Miami Dade Blue Select $24 168%
Avmed Exchange $25 175%
Ambetter / Centene $26 182%
Molina Marketplace Program Exchange $27 189%
Auto Insurance $29 203%
Avmed Select Network $29 203%
Amerihealth Caritas Next Exchange $31 217%
Liga Contra El Cancer $59 413%
Bc/Bs Of Fl Phs $60 420%
Magellan Behavioral Health $71 498%
Dimensions International $77 540%
First Health $80 561%
Dimension Health Ppo $89 624%
Beacon Health Strategies Commercial $119 834%
Commercial Non-Contracted $119 834%
Self Pay - Mcd Pending 100 Percent $119 834%
Single Case Agreement $119 834%
United Behavioral Health Psych $119 834%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 W 68Th St, Hialeah, FL 33016
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals