CMS Price Transparency Data

Hepatitis C antibody test

Facility: Sarasota Memorial Hospital - Venice

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $94
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 6.59x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Sarasota Memorial Hospital - Venice is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.59x the Medicare baseline. Located in 2600 Laurel Road East, North Venice, FL.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $63 (441%)
Insurance Median: $94 (659%)
Cash: $63 (441% of Medicare)
Ins. Median: $94 (659% 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 659% of the Medicare baseline (a markup of 559%). 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
Amerihealth Caritas $6 42%
Community Care Plan $6 42%
Florida Community Care $6 - $16 42%
Molina $6 42%
Simply Healthcare $6 42%
Sunshine State $6 42%
Blue Cross Blue Shield $14 98%
UnitedHealthcare $14 - $135 98%
Aetna $15 - $144 105%
Simply Freedom Optimum $15 105%
Wellcare $15 105%
Ambetter / Centene $39 273%
Avmed $98 - $131 687%
Careworks $105 - $133 736%
Enlyte $105 - $133 736%
Usa Managed Care $107 - $144 750%
First Health $111 - $149 778%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2600 Laurel Road East, North Venice, FL 34275
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals