CMS Price Transparency Data

Hepatitis C antibody test

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $362
  • Cash Discount Price: $316
  • vs. Medicare Baseline: 25.37x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Ann & Robert H Lurie Childrens Hospital of Chicago is $362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $316. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 25.37x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$316

Average discount available for prompt cash payment at this facility.

Insurance Median
$362

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: $316 (2214%)
Insurance Median: $362 (2537%)
Cash: $316 (2214% of Medicare)
Ins. Median: $362 (2537% 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 2537% of the Medicare baseline (a markup of 2437%). 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
Medicare (plans) $77 - $2,656 540%
UnitedHealthcare $84 - $92 589%
Mercycare Health $167 1170%
Cigna $190 - $321 1331%
Blue Cross Blue Shield $196 - $362 1374%
Aetna $226 - $354 1584%
Beacon Health Options $226 1584%
La Rabida Childrens Hospital $226 1584%
Centegra $271 1899%
Independent Physicians At Mercy $271 1899%
Advanced Physicians Association Ipa $316 2214%
Health Plus $316 2214%
Imagine Health $316 2214%
Methodist First Choice $316 2214%
Northwest Community Healthcare $316 2214%
Presence Health Partners $316 2214%
St. Francis $316 2214%
Ui Health $316 2214%
West Suburban Health Providers $316 2214%
Shriners Hospital $339 2376%
Swedish Covenant Physician Partners $339 2376%
American Psych Systems $362 2537%
Health Alliance $362 2537%
Macneal Health $362 2537%
Magellan $362 - $900 2537%
Healthlink Inc. $373 2614%
Cofinity $384 2691%
Hfn Inc $384 - $407 2691%
Humana $384 2691%
Principal Healthcare $384 2691%
St. Elizabeth $384 2691%
First Health $398 2789%
Healthstar $398 2789%
Preferred Health Network $398 2789%
Sagamore Health Network $398 2789%
Beech Street $407 2852%
Benchmark Health $407 2852%
Employer'S Coalition On Health $407 2852%
Private Health Care System $407 2852%
Security Health Plan $407 2852%
Swedish American $407 2852%
Wellmark/Healthnetwork $416 2915%
Health Smart $429 3006%
Integrated Health Plan $429 3006%
Multiplan $429 3006%
National Provider Network $429 3006%
Wea Insurance Group $429 3006%
Unicare $3,678 - $8,500 25774%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens