CMS Price Transparency Data

Hepatitis C antibody test

Facility: Frisbie Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $63
  • Cash Discount Price: $247
  • vs. Medicare Baseline: 4.41x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Frisbie Memorial Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.41x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.
Cash / Self-Pay
$247

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $247 (1731%)
Insurance Median: $63 (441%)
Cash: $247 (1731% of Medicare)
Ins. Median: $63 (441% 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 441% of the Medicare baseline (a markup of 341%). 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
Amerihealth Caritas $13 91%
Well Sense Health Plan $13 91%
Aetna $14 - $143 98%
Blue Cross Blue Shield $14 - $99 98%
Humana $14 98%
United VA Ccn $14 98%
Cigna $15 - $314 105%
Evernorth Behavioral Health $15 105%
Martin's Point Health $15 105%
United $15 - $149 105%
Ambetter / Centene $25 175%
Harvard Pilgrim $66 - $100 463%
Maine Community Health $70 - $119 491%
Tufts Health Plan $85 - $141 596%
Evernorth $198 1388%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 Whitehall Road, Rochester, NH 03867
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals