CMS Price Transparency Data

Hepatitis C antibody test

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $16
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Physicians Regional Medical Center - Pine Ridge is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.12x the Medicare baseline. Located in 6101 Pine Ridge Road, Naples, FL.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $17 (119%)
Insurance Median: $16 (112%)
Cash: $17 (119% of Medicare)
Ins. Median: $16 (112% 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
Amerigroup $6 42%
Childrens Medical Services $6 42%
Humana $6 - $14 42%
Integral Health $6 42%
Magellan $6 42%
Medicaid / KanCare $6 42%
Prestige Health $6 42%
Simply Healthcare Plan $6 42%
UnitedHealthcare $6 - $21 42%
Wellcare $6 42%
Self Pay $12 - $21 84%
Aetna $14 - $59 98%
Blue Cross Blue Shield $14 - $89 98%
Freedom Optimum $14 98%
Medicare (plans) $14 98%
Node Non Par Hospice Agree $14 98%
Node Va $14 98%
Occunet $14 - $36 98%
Tricare $14 98%
Veterans Eval Services $14 98%
Cigna $15 105%
Node Champva $15 105%
Node Wellcare Mcr Adv $15 105%
Florida Workers Compensation $16 112%
Prime Health Work Comp Fl $16 112%
Rockport $16 112%
Node Us Dept Of Labor $18 126%
Simply Healthcare $21 - $27 147%
Avmed $25 - $34 175%
Florida State Auto Insurance $29 203%
Ambetter / Centene $36 252%
Community Health Partners $73 512%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6101 Pine Ridge Road, Naples, FL 34119
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals