CMS Price Transparency Data

Hepatitis C antibody test

Facility: St Lucie Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St Lucie Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 1800 Se Tiffany Ave, Port Saint Lucie, FL.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $39 (273%)
Insurance Median: $14 (98%)
Cash: $39 (273% of Medicare)
Ins. Median: $14 (98% 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
Freedom Health $3 - $6 21%
Optimum $3 21%
Avmed $5 - $20 35%
Simply Healthcare Plans $5 35%
Molina $7 - $11 49%
Health Sun Health Plan $8 56%
Sunshine State Health Plan $10 70%
Aetna $12 - $15 84%
Careplus $14 98%
Devoted Health $14 98%
Hospice Of Treasure Coast $14 98%
Hospice Treasure Coast $14 98%
Humana $14 - $16 98%
Ndms Definitive Care $14 98%
United $14 - $18 98%
United Behavioral Health $14 98%
Veterans Evaluation Services $14 98%
Wellmed $14 98%
American Health Plan $15 105%
Blue Cross Blue Shield $15 105%
Cigna $15 105%
Florida Complete Care $15 105%
Prominence Healthfirst $15 105%
Sunshine State $15 - $16 105%
Ultimate Health Plan $15 105%
Centurion $16 112%
Amerihealth Caritas $17 119%
Longevity Health Plan $17 119%
United Ppo $17 119%
Plotkin Health $20 140%
Prime Health Sherriff $20 140%
Solis Health Plan $21 147%
Oscar $28 196%
Multiplan $29 - $33 203%
Simply Healthcare $32 224%
Corvel Corporation $125 876%
Careworks (Rockport) $128 897%
Prime Health $128 897%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1800 Se Tiffany Ave, Port Saint Lucie, FL 34952
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals