CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Florida Palms West Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $53
  • Cash Discount Price: $404
  • vs. Medicare Baseline: 3.71x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Florida Palms West Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.71x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.
Cash / Self-Pay
$404

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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: $404 (2831%)
Insurance Median: $53 (371%)
Cash: $404 (2831% of Medicare)
Ins. Median: $53 (371% 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 371% of the Medicare baseline (a markup of 271%). 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
Careplus Sfl $14 98%
Devoted Health $14 98%
Humana $14 - $137 98%
Ndms Definitive Care $14 98%
United $14 - $182 98%
Veterans Evaluation Services $14 98%
Wellmed $14 98%
Aetna $15 - $121 105%
Align $15 105%
American Health Plan $15 105%
Blue Cross Blue Shield $15 105%
Cigna $15 105%
Florida Complete Care $15 105%
Oscar $15 - $20 105%
Prominence Healthfirst $15 105%
Sunshine State $15 - $16 105%
Centurion $16 112%
Doctors Healthcare Plan $16 112%
Gold Kidney $16 112%
Amerihealth Caritas $17 - $21 119%
Longevity Health Plan $17 119%
Simply Healthcare $18 126%
Solis Health Plan $21 147%
Freedom Health $35 - $65 245%
Optimum $35 245%
Avmed $53 - $202 371%
Simply Healthcare Plans $53 371%
Molina $77 - $109 540%
Health Sun Health Plan $86 603%
Aids Healthcare $89 - $485 624%
Mmm Of Fl (Health Advantage Plan) $93 652%
United Ppo $96 673%
Sunshine State Health Plan $105 736%
Corvel Corporation $126 883%
Careworks (Rockport) $129 904%
Prime Health $129 904%
Health Care District $202 1416%
Palm Beach Juvenile Correction $202 1416%
Plotkin Health $202 1416%
Prime Health Sherriff $202 1416%
Medica Healthcare $234 1640%
Multiplan $303 - $343 2123%
Healthy Palm Beaches $550 3854%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13001 Southern Blvd, Loxahatchee, FL 33470
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals