CMS Price Transparency Data

Hepatitis C antibody test

Facility: Gulf Breeze Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $22
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Gulf Breeze Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.54x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.
Cash / Self-Pay
$11

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $11 (77%)
Insurance Median: $22 (154%)
Cash: $11 (77% of Medicare)
Ins. Median: $22 (154% 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 $6 - $53 42%
Cha Health Plan $6 42%
Fl Community Care Ltc $6 42%
Humana $6 - $15 42%
Sunshine Health $6 42%
UnitedHealthcare $6 - $14 42%
Wellcare $6 - $15 42%
Simply Healthcare Healthy Kids $7 49%
Pensacola $11 77%
Hospice Covenant $14 98%
Medicare (plans) $14 98%
Hospice Regency $22 154%
Fl Blue $24 - $333 168%
Cigna $35 - $73 245%
Hospice Emerald Coast $36 252%
Private Healthcare $47 329%
Uwf Athletes $47 329%
First Health $51 357%
Choicecare $55 385%
Multiplan $65 456%
Wc Corvel $69 - $108 484%
Bc Fl $208 1458%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1110 Gulf Breeze Pkwy, Gulf Breeze, FL 32561
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals