CMS Price Transparency Data

Hepatitis C antibody test

Facility: Carolina East Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $82
  • Cash Discount Price: $67
  • vs. Medicare Baseline: 5.75x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Carolina East Medical Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.75x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$67

Average discount available for prompt cash payment at this facility.

Insurance Median
$82

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: $67 (470%)
Insurance Median: $82 (575%)
Cash: $67 (470% of Medicare)
Ins. Median: $82 (575% 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 575% of the Medicare baseline (a markup of 475%). 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
Humana $14 98%
Inclusive Health (Nchirp)-All Plans $14 98%
Pamlico Co Jail-All Plans $30 210%
Craven Co. Jail Systems - All Plans $38 266%
Medcost Ppo Ultra (Employees) $70 491%
Medcost Ppo Employees And Retirees $74 519%
Blue Cross Blue Shield $77 540%
UnitedHealthcare $80 561%
Medcost Ppo City Employees $82 575%
Medcost Ppo County Employee $85 596%
Benefit Mgmt, Svcs-All Plans $96 673%
Medcost Benefit Svc-All Other Plans $99 694%
Aetna $100 701%
Acs Consult Svc Inc-All Plans $101 708%
Medcost Ppo Standard $101 708%
Cigna $102 715%
Tricare $112 785%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals