CMS Price Transparency Data

Hepatitis C antibody test

Facility: Hackensack University Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $115
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 8.06x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Hackensack University Medical Center is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.06x the Medicare baseline. Located in 30 Prospect Ave, Hackensack, NJ.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $14 (98%)
Insurance Median: $115 (806%)
Cash: $14 (98% of Medicare)
Ins. Median: $115 (806% 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 806% of the Medicare baseline (a markup of 706%). 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
Aetna $11 - $538 77%
UnitedHealthcare $11 - $84,414 77%
Horizon $13 - $2,092 91%
Amerigroup $14 98%
Blue Cross Blue Shield $14 98%
Clover $14 98%
Seoul Medical Group $14 98%
Vaccn $14 98%
Wellcare $14 98%
United Community/Americhoice $15 105%
Lhp Health $18 126%
Karna $19 133%
Oxford $22 - $1,576 154%
Intergroup $31 - $1,502 217%
Bergen Risk $33 - $1,609 231%
Brighton Health Plan $35 - $1,930 245%
Cigna $35 - $1,716 245%
Activecare First McO $37 - $1,823 259%
Chn $37 - $1,823 259%
Multiplan - PHCS $37 - $1,823 259%
Qualcare $39 - $1,892 273%
Amerihealth $44 - $2,145 308%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 30 Prospect Ave, Hackensack, NJ 07601
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals