CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Florida Fort Walton-Destin Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $92
  • Cash Discount Price: $599
  • vs. Medicare Baseline: 6.45x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Florida Fort Walton-Destin Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $599. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.45x the Medicare baseline. Located in 1000 Mar-Walt Dr, Fort Walton Beach, FL.
Cash / Self-Pay
$599

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $599 (4198%)
Insurance Median: $92 (645%)
Cash: $599 (4198% of Medicare)
Ins. Median: $92 (645% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 645% of the Medicare baseline (a markup of 545%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 - $228 91%
Ndms Definitive Care $14 98%
Triwest Healthcare Alliance $14 98%
United $14 - $270 98%
United Behavioral Health $14 98%
Veterans Evaluation Services $14 98%
Wellmed $14 98%
Aetna $15 - $180 105%
Align Senior Care $15 105%
American Health Plan $15 105%
Blue Cross Blue Shield $15 105%
Florida Complete Care $15 105%
Healthspring Of Florida $15 105%
Sunshine State $15 105%
Wellcare $15 105%
Centurion $16 112%
Clear Spring Health $16 112%
Gold Kidney Of Florida $16 112%
Ultimate Health Plan $16 112%
Longevity Health Plan $17 119%
Oscar $19 133%
Simply Healthcare $22 154%
Simply $92 645%
Molina Healthcare $114 - $192 799%
Corvel Corporation $121 848%
Prime Health $124 869%
Careworks (Rockport Community) $128 897%
Avmed $144 - $300 1009%
Sunshine State Health Plan $153 1072%
Plotkin Health $300 2102%
Prime Health Sheriff $300 2102%
Evolutions Healthcare $390 - $539 2733%
Naphcare $390 2733%
Multiplan $467 - $509 3273%
Evernorth $479 3357%
Ppo Next $509 3567%
Novanet $539 3777%
Beacon Health Options $599 4198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Mar-Walt Dr, Fort Walton Beach, FL 32547
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals