CMS Price Transparency Data

Hepatitis C antibody test

Facility: Shirley Ryan Abilitylab

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $159
Cash Discount Price: $145
vs. Medicare Baseline: 11.14x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Shirley Ryan Abilitylab is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 11.14x the Medicare baseline. Located in 355 E Erie St, Chicago, IL.

Cash / Self-Pay

$145

Average discount available for prompt cash payment at this facility.

Insurance Median

$159

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: $145 (1016%)

Insurance Median: $159 (1114%)

Cash: $145 (1016% of Medicare)

Ins. Median: $159 (1114% 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 1114% of the Medicare baseline (a markup of 1014%). 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
Uic Physician Group-Campuscare	$94 - $148	659%
Personalcare Insurance Of Il/Firsthealth Grp Corp/Coventryhealth And Life Insurance Co	$99 - $252	694%
State Of Illinois	$99 - $157	694%
Affordable Health Care Concepts	$112 - $178	785%
University Of Chicago Practice Plan	$122 - $192	855%
Health Care Services Corporation Dba Managed Care Network Preferred	$127 - $202	890%
Gallagher Benefit Administrators	$140 - $222	981%
Unicare Life And Health Insurance	$146 - $231	1023%
Private Healthcare Systems	$150 - $237	1051%
Resurrection Health Care Preferred	$150 - $237	1051%
Uic Physician Group	$151 - $240	1058%
Cofinity Aka Ppom	$159 - $252	1114%
Health Payors Organization	$159 - $252	1114%
Healthnetwork	$165 - $260	1156%
Hfn	$168 - $266	1177%

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 $145.
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 Shirley Ryan Abilitylab 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.