CMS Price Transparency Data

Hepatitis C antibody test

Facility: Portsmouth Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $76
  • Cash Discount Price: $311
  • vs. Medicare Baseline: 5.33x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Portsmouth Regional Hospital is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.33x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.
Cash / Self-Pay
$311

Average discount available for prompt cash payment at this facility.

Insurance Median
$76

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: $311 (2179%)
Insurance Median: $76 (533%)
Cash: $311 (2179% of Medicare)
Ins. Median: $76 (533% 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 533% of the Medicare baseline (a markup of 433%). 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 - $197 98%
Humana $14 98%
Martin'S Point Health $14 - $15 98%
United Behavioral Health $14 98%
United Va Ccn $14 98%
Blue Cross Blue Shield $15 - $138 105%
Cigna $15 - $75 105%
Evernorth Behavioral Health $15 105%
Sierra Military Health $15 105%
United $15 - $205 105%
Ambetter / Centene $25 175%
Harvard Pilgrim $61 - $134 427%
Maine Community Health $97 - $165 680%
Tufts Health Plan $117 - $178 820%
Mvp Health Plan $218 1528%
Corvel $224 1570%
Evernorth $249 1745%
Mutual Of Omaha $249 1745%
Multiplan $252 1766%
First Health $283 1983%
Healthcare Value Mgmt $283 1983%
Oxford Health Plans $295 2067%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 333 Borthwick Ave, Portsmouth, NH 03801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals