CMS Price Transparency Data

Hepatitis C antibody test

Facility: North Carolina Baptist Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $86
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 6.03x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at North Carolina Baptist Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.03x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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: $129 (904%)
Insurance Median: $86 (603%)
Cash: $129 (904% of Medicare)
Ins. Median: $86 (603% 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 603% of the Medicare baseline (a markup of 503%). 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 $14 - $224 98%
Apex $14 98%
Blue Cross Blue Shield $14 - $98 98%
Cigna $14 - $158 98%
Devoted $14 98%
Healthteam $14 98%
Humana $14 - $144 98%
Medicare (plans) $14 98%
UnitedHealthcare $14 - $91 98%
Wellcare $14 - $26 98%
Liberty $16 112%
Alliance $26 182%
Amerihealth $26 - $63 182%
Carolina Complete $26 182%
Health Blue $26 182%
Partners $26 182%
Vaya $26 182%
Trillium $27 189%
Medcost $38 - $176 266%
Ambetter / Centene $56 - $60 392%
Oscar $75 - $95 526%
Directnet $148 - $156 1037%
Cone Health $175 - $185 1226%
Healthgram $175 - $185 1226%
First Carolina Care $200 - $211 1402%
Private Healthcare Systems $205 - $216 1437%
Multiplan $225 - $238 1577%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals