CMS Price Transparency Data

Hepatitis C antibody test

Facility: Children's Nebraska

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $148
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 10.37x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Children's Nebraska is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 10.37x the Medicare baseline. Located in 8200 Dodge St, Omaha, NE.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$148

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%)
Insurance Median: $148 (1037%)
Ins. Median: $148 (1037% 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 1037% of the Medicare baseline (a markup of 937%). 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
Ambetter / Centene $14 98%
Medicaid / KanCare $14 - $64 98%
Molina (Iowa) $14 98%
Wellpoint $14 98%
Molina (Nebraska) $20 140%
Midlands Choice Chi $144 1009%
Blue Cross Blue Shield $148 - $165 1037%
UnitedHealthcare $157 - $173 1100%
Midlands Choice Elevate $165 1156%
Avera Health Plan $175 1226%
Centivo $175 1226%
Wellmark $175 1226%
Aetna $181 1268%
Midlands Choice $181 1268%
Sanford Health Plan $181 1268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8200 Dodge St, Omaha, NE 68114
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens