CMS Price Transparency Data

Hepatitis C antibody test

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $92
Cash Discount Price: $162
vs. Medicare Baseline: 6.45x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Children's Healthcare of Atlanta at Scottish Rite is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.45x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$162

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $162 (1135%)

Insurance Median: $92 (645%)

Cash: $162 (1135% of Medicare)

Ins. Median: $92 (645% 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 645% of the Medicare baseline (a markup of 545%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Caresource [61]	$11	77%
Peachstate [43]	$11	77%
Amerigroup [102]	$13	91%
Blue Cross Blue Shield	$48 - $471	336%
Cigna	$48 - $319	336%
United [5]	$48 - $320	336%
Aetna	$49 - $324	343%
Ambetter / Centene	$49 - $323	343%
Oscar [228]	$49 - $323	343%
Caresource Marketplace Bronze/Silver/Gold [60]	$50 - $328	350%
Kaiser [6]	$50 - $328	350%
Sidecar Health [236]	$50 - $333	350%
Coventry [9]	$51 - $338	357%
Direct Employer Agreements [72]	$51 - $410	357%
First Health [74]	$55 - $362	385%
Northeast Georgia Heatlh System [808]	$55 - $362	385%
Veracity Benefits [809]	$55 - $362	385%
Phcs [93]	$62 - $410	434%
Secure Health [340]	$62 - $410	434%
Beech Street [71]	$66 - $434	463%
Multiplan [92]	$72 - $472	505%
Novanet [41]	$73 - $482	512%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $162.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Children's Healthcare of Atlanta at Scottish Rite is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.