CMS Price Transparency Data

Hepatitis C antibody test

Facility: Novant Health Presbyterian Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $122
Cash Discount Price: $98
vs. Medicare Baseline: 8.55x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Novant Health Presbyterian Medical Center is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.55x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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: $98 (687%)

Insurance Median: $122 (855%)

Cash: $98 (687% of Medicare)

Ins. Median: $122 (855% 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 855% of the Medicare baseline (a markup of 755%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Amerihealth	$9 - $51	63%
Blue Cross Blue Shield	$9 - $207	63%
Carolina Complete	$9 - $50	63%
Nc Department Of Public Safety	$9 - $50	63%
UnitedHealthcare	$9 - $168	63%
Wellcare	$9 - $51	63%
Humana	$14 - $207	98%
Pace Of The Southern Piedmont	$14	98%
Aetna	$15 - $230	105%
Cigna	$15 - $148	105%
Liberty Health	$15	105%
Caresource North Carolina	$17 - $95	119%
Atlantic Corporation Dba Atlantic Packaging	$24 - $132	168%
Amps	$29 - $158	203%
Plotkin Health	$32 - $173	224%
Medcost	$38 - $216	266%
Primary Physician Care	$39 - $213	273%
Multiplan	$40 - $216	280%
Phcs	$40 - $216	280%
Employers Choice Network	$51 - $279	357%
Three Rivers Provider Network	$51 - $279	357%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $98.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Novant Health Presbyterian Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.