CMS Price Transparency Data

Hepatitis C antibody test

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $60
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at The Orthopaedic Hospital of Lutheran Health Networ is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.20x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $102 (715%)
Insurance Median: $60 (420%)
Cash: $102 (715% of Medicare)
Ins. Median: $60 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
Blue Cross Blue Shield $6 - $23 42%
Physicians Health Plan $12 - $174 84%
Tricare $13 91%
UnitedHealthcare $13 - $221 91%
Aetna $14 - $218 98%
Amish Aid $14 - $121 98%
Caresource $14 98%
Department Of Veterans Affairs $14 98%
Humana $14 98%
Iu Health Plan $14 98%
Managed Health Services $14 - $29 98%
Medicaid / KanCare $14 98%
Medicare (plans) $14 98%
Mhs $14 98%
Node Devoted Health Mcr Adv $14 98%
Node Hospice Non Par Agree $14 98%
Node Mhs Mcr Adv $14 98%
Node Va $14 98%
One Call Work Comp $14 98%
Self Pay $14 - $121 98%
Small Business Aid $14 98%
In Dept Of Correction $15 105%
Lutheran Preferred $15 - $269 105%
Node Pphp Mcr Adv $15 105%
Police And Sheriff $15 105%
Php Freedom Network $16 - $26 112%
Cigna $18 - $449 126%
Node Us Dept Of Labor $18 126%
Lutheran Advanced Network $21 147%
Node Lutheran Three Rivers Preferred Plus 150 $21 147%
Occunet In Work Comp $21 147%
Three Rivers Preferred $21 - $202 147%
Align Network $23 161%
Node Lutheran Three Rivers Preferred Plus 175 $25 175%
Sagamore $25 - $243 175%
Encore Ppo $26 - $224 182%
Encore Wc $26 182%
Medrisk In Work Comp $26 182%
Prime Health Services $26 - $337 182%
Three Rivers Preferred In Work Comp $26 182%
Objective Surgical $28 196%
In Work Comp $29 203%
Lutheran Network $29 203%
Encore Kba Epo $34 238%
Multiplan $36 - $350 252%
First Health $40 - $346 280%
Encore $42 - $359 294%
Encore Kba Ppo $43 301%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals