CMS Price Transparency Data

Hepatitis C antibody test

Facility: Northwestern Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $160
Cash Discount Price: $117
vs. Medicare Baseline: 11.21x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Northwestern Memorial Hospital is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 11.21x the Medicare baseline. Located in 251 E Huron St, Chicago, IL.

Cash / Self-Pay

$117

Average discount available for prompt cash payment at this facility.

Insurance Median

$160

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: $117 (820%)

Insurance Median: $160 (1121%)

Cash: $117 (820% of Medicare)

Ins. Median: $160 (1121% 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 1121% of the Medicare baseline (a markup of 1021%). 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
Curaechoice [6100]	$20 - $108	140%
Aetna	$23 - $461	161%
Imagine Health [6032]	$43 - $124	301%
Humana	$48 - $230	336%
Global Medical Management Inc [6090]	$50 - $267	350%
Healthlink [125]	$60 - $461	420%
Medpartners [6038]	$60 - $323	420%
Blue Cross Blue Shield	$72 - $461	505%
Health'S Finest Network [126]	$77 - $331	540%
Cigna	$95 - $461	666%
Multiplan/Phcs [142]	$95 - $461	666%
Galaxy Health Network [220]	$119 - $461	834%
UnitedHealthcare	$119 - $461	834%
First Health Plan [6034]	$160 - $461	1121%

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 $117.
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 Northwestern Memorial Hospital 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.