CMS Price Transparency Data

Hepatitis C antibody test

Facility: Norton-King's Daughters' Health

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $177
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 12.40x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Norton-King's Daughters' Health is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 12.40x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$177

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: $50 (350%)
Insurance Median: $177 (1240%)
Cash: $50 (350% of Medicare)
Ins. Median: $177 (1240% 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 1240% of the Medicare baseline (a markup of 1140%). 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
Aetna $11 - $198 77%
Blue Cross Blue Shield $14 - $44 98%
Humana $14 98%
Managed Health Services Of Indiana $14 98%
Managed Health Services Of Kentucky $14 98%
Passport By Molina $14 98%
UnitedHealthcare $14 - $177 98%
Managed Health Services $15 - $22 105%
Caresource Of Kentucky $20 140%
Caresource Of Indiana $21 147%
Custom Design Benefits $29 - $112 203%
Cigna $191 1338%
Encore $191 1338%
Quality Care Partners $200 1402%
Bluegrass $202 1416%
First Health $202 1416%
Healthlink $202 1416%
Vha/Tristate $202 1416%
Multiplan/Phcs $207 1451%
Indiana Health Network $214 1500%
Siho $214 1500%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals