CMS Price Transparency Data

Hepatitis C antibody test

Facility: Alice Peck Day Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $101
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 7.08x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Alice Peck Day Memorial Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 7.08x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $74 (519%)
Insurance Median: $101 (708%)
Cash: $74 (519% of Medicare)
Ins. Median: $101 (708% 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 708% of the Medicare baseline (a markup of 608%). 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 $11 77%
Amerihealth Caritas Granite Mcmp $12 84%
Medicaid / KanCare $12 84%
Nh Healthy Families $12 84%
Blue Cross Blue Shield $68 - $123 477%
Wellpoint $83 582%
Harvard Pilgrim $86 - $120 603%
UnitedHealthcare $99 694%
Tufts $101 708%
Cigna $106 - $113 743%
Commercial Generic $106 743%
Connecticut General $106 743%
Klais $107 750%
Aetna $124 869%
Mvp $126 883%
Coventry Health $131 918%
Coventry Health Wc $131 918%
Humana $144 1009%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Alice Peck Day Drive, Lebanon, NH 03766
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals