CMS Price Transparency Data

Hepatitis C antibody test

Facility: Medstar Harbor Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $74
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 5.19x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Medstar Harbor Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.19x the Medicare baseline. Located in 3001 South Hanover Street, Baltimore, MD.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $73 (512%)
Insurance Median: $74 (519%)
Cash: $73 (512% of Medicare)
Ins. Median: $74 (519% 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 519% of the Medicare baseline (a markup of 419%). 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 $74 519%
Amerigroup $74 519%
Amerihealth Caritas District Of Columbia $74 519%
Carefirst Advantage Inc $74 519%
Carefirst Blue Choice Inc $74 519%
Cigna $74 519%
First Health $74 519%
Hscsn $74 519%
Humana $74 519%
Kaiser Permanente $74 519%
Magellan Behavioral Health Inc $74 519%
Mamsi $74 519%
Medstar Family Choice $74 519%
Medstar Family Choice Inc $74 519%
Ncppo Healthlink Ppo $74 519%
Pfc $74 519%
Private Healthcare Systems (Phcs) $74 519%
Tricare $74 519%
United Behavioral Health Inc $74 519%
UnitedHealthcare $74 519%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3001 South Hanover Street, Baltimore, MD 21225
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals