CMS Price Transparency Data

Hepatitis C antibody test

Facility: Boston Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $16
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Boston Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.12x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $45 (315%)
Insurance Median: $16 (112%)
Cash: $45 (315% of Medicare)
Ins. Median: $16 (112% 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.

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
Medicaid / KanCare $12 - $13 84%
Cigna $13 - $39 91%
Fallon Healthcre Aco [1121] $13 91%
Hlth New England Aco [1123] $13 91%
Mass General Brigham Health Plan Aco [1120] $13 91%
Mass General Brigham Health Plan Mcd Mnged [1107] $13 91%
Oxford Health [1007] $13 91%
Oxford Health [2024] $13 91%
Tufts Together Aco [1122] $13 91%
Tufts Together Mco [1125] $13 91%
United [2025] $13 - $43 91%
UnitedHealthcare $13 - $14 91%
Wellsense Alli Aco [1118] $13 91%
Wellsense Essential Mco [1101] $13 91%
Zzzunited [1008] $13 - $43 91%
Aetna $14 - $59 98%
Blue Cross Blue Shield $14 - $28 98%
Corrections [9001] $14 - $18 98%
Humana $14 98%
Medicare (plans) $14 - $15 98%
Neighborhood Pace [1206] $14 98%
Tufts [8002] $14 - $39 98%
Ubh Hphc [8016] $14 98%
Veterans Admin [9003] $14 98%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010] $14 98%
Cca [1215] $15 105%
Eternalhealth [1227] $15 105%
Wellcare [1240] $15 105%
Wellsense [7001] $15 105%
Zzzcca Onecare [1216] $15 105%
Fallon Sco [1126] $16 112%
Workers Comp [5002] $16 112%
Zzzbu Employee Work Comp [5004] $16 112%
Zzzcity Of Boston Work Comp [5003] $16 112%
Champva [9004] $17 119%
Senior Whole Health [1210] $17 119%
Tricare $17 119%
Tufts Conncare/Qhp [8020] $17 - $20 119%
Fallon [8008] $19 133%
Unicare [8004] $20 140%
Wellpoint [2034] $20 140%
Uphams Corner Esp [1213] $32 - $48 224%
Meritain Health [1023] $35 - $53 245%
Harvard Pilgrim Health Care [8001] $43 301%
Health Plans Inc [2027] $43 301%
Mass General Brigham Health Plan Commercial [8009] $43 - $65 301%
Zzzhealth Plans Inc [1013] $43 301%
Hsn Bad Debt [4003] $513 3595%
Hsn Confidential [4007] $513 3595%
Hsn Dental [4006] $513 3595%
Hsn Partial [4002] $513 3595%
Hsn [4001] $513 3595%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Boston Medical Center Place, Boston, MA 02118
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals