CMS Price Transparency Data

Hepatitis C antibody test

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $260
  • Cash Discount Price: $447
  • vs. Medicare Baseline: 18.22x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at University Medical Center of Princeton at Plainsboro is $260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $447. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 18.22x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$447

Average discount available for prompt cash payment at this facility.

Insurance Median
$260

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: $447 (3132%)
Insurance Median: $260 (1822%)
Cash: $447 (3132% of Medicare)
Ins. Median: $260 (1822% 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 1822% of the Medicare baseline (a markup of 1722%). 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 $14 - $372 98%
Blue Cross Blue Shield $14 - $336 98%
Medicare (plans) $14 - $16 98%
UnitedHealthcare $14 - $29 98%
Va Medical Center $14 98%
Cigna $15 - $447 105%
Clover Health Plan $15 105%
Humana $15 105%
Tricare $17 119%
Us Family Health Plan $17 119%
Charity Care $19 133%
Medicaid / KanCare $19 - $447 133%
Elap $20 - $26 140%
Wellcare $21 147%
Centivo $26 182%
Claim Watcher $26 182%
Horizon Nj Health $33 231%
Amerihealth $38 266%
Preferred Health Care Eliance $116 813%
Horizon Behavioral Health $168 1177%
Beacon Health Options $224 1570%
Magnacare $268 - $313 1878%
Princeton Theological Seminary $291 2039%
Coventry $313 2193%
Health Net $313 2193%
Beech Street $358 - $380 2509%
Intergrated Health Plan $358 2509%
Intergroup $358 2509%
Penn Global Medicine Embassy Only $358 2509%
Allied Trades $380 2663%
Consumer Health Network $380 2663%
Devon Health Services $380 2663%
First Managed Care Option $380 2663%
Ie Shaffer $380 2663%
Private Healthcare Systems $380 2663%
Qualcare $380 2663%
Total Care Network $380 2663%
Tri-State $380 2663%
Commercial Other $447 3132%
Compsych $447 3132%
Concern Plus $447 3132%
International Pfs $447 3132%
Life St. Francis $447 3132%
Magellan $447 3132%
Managed Health Network $447 3132%
Nj Carpenters $447 3132%
Penn Behavioral Health Corporate Services $447 3132%
Personnel Health Program $447 3132%
United Behavioral Health $447 3132%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals