CMS Price Transparency Data

Hepatitis C antibody test

Facility: Novant Health Ballantyne Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $152
Cash Discount Price: $125
vs. Medicare Baseline: 10.65x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Novant Health Ballantyne Medical Center is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 10.65x the Medicare baseline. Located in 10905 Providence Road W, Charlotte, NC.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $125 (876%)

Insurance Median: $152 (1065%)

Cash: $125 (876% of Medicare)

Ins. Median: $152 (1065% 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 1065% of the Medicare baseline (a markup of 965%). 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
Blue Cross Blue Shield	$14 - $207	98%
Humana	$14 - $207	98%
Pace Of The Southern Piedmont	$14	98%
UnitedHealthcare	$14 - $168	98%
Aetna	$15 - $230	105%
Cigna	$15 - $148	105%
Liberty Health	$15	105%
Nc Department Of Public Safety	$29 - $59	203%
Carolina Complete	$43 - $59	301%
Amerihealth	$44 - $60	308%
Wellcare	$44 - $60	308%
Caresource North Carolina	$70 - $95	491%
Atlantic Corporation Dba Atlantic Packaging	$97 - $132	680%
Amps	$116 - $158	813%
Plotkin Health	$127 - $173	890%
Medcost	$150 - $216	1051%
Primary Physician Care	$156 - $213	1093%
Multiplan	$158 - $216	1107%
Phcs	$158 - $216	1107%
Employers Choice Network	$205 - $279	1437%
Three Rivers Provider Network	$205 - $279	1437%

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 $125.
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 Ballantyne 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.