CMS Price Transparency Data

Hepatitis C antibody test

Facility: Marion Communtiy Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $17
  • Cash Discount Price: $127
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Marion Communtiy Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.19x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$127

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $127 (890%)
Insurance Median: $17 (119%)
Cash: $127 (890% of Medicare)
Ins. Median: $17 (119% 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 $13 - $25 91%
Devoted Health $14 98%
Ndms Definitive Care $14 98%
United $14 - $57 98%
Va Purchased Care Program $14 98%
Veterans Evaluation Services $14 98%
Wellmed $14 98%
Align Senior Care $15 105%
American Health Plan $15 105%
Avmed $15 - $36 105%
Blue Cross Blue Shield $15 105%
Cigna $15 105%
Florida Complete Care $15 105%
Freedom Optimum $15 105%
Secur $15 105%
Sunshine State $15 105%
Wellcare $15 105%
Aetna $16 - $38 112%
Careplus $16 112%
Centurion $16 112%
Clear Spring Health $16 112%
Gold Kidney Of Florida $16 112%
Ultimate Health Plan $16 112%
Longevity Health Plan $17 119%
Simply Healthcare $18 126%
Simply $20 140%
Molina Healthcare $24 - $41 168%
Evolutions $29 203%
Evolutions Healthcare $29 203%
Naphcare $30 - $34 210%
University Ma Federal Corrections $30 210%
Wellpath $30 - $34 210%
Sunshine State Health Plan $32 224%
Plotkin Health $64 448%
Prime Health Sheriff $64 448%
Multiplan $99 694%
Ppo Next $108 757%
Corvel Corporation $114 799%
Novanet $115 806%
Prime Health $117 820%
Careworks (Rockport Community) $120 841%
Marion County Schools $120 841%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals