CMS Price Transparency Data

Hepatitis C antibody test

Facility: Trinitas Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $29
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 2.03x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Trinitas Regional Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.03x the Medicare baseline. Located in 225 Williamson Street, Elizabeth, NJ.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $16 (112%)
Insurance Median: $29 (203%)
Cash: $16 (112% of Medicare)
Ins. Median: $29 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
UnitedHealthcare $7 - $15 49%
Wellpoint $12 - $14 84%
Fidelis Care $14 98%
Blue Cross Blue Shield $14 - $140 98%
Humana $14 98%
Aetna $14 - $87 98%
Clover Health $14 98%
Qualcare Inc $19 133%
Wellcare $28 196%
Emblem Health $29 203%
Cigna $59 413%
Amerihealth $60 420%
First Health $131 918%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 Williamson Street, Elizabeth, NJ 07207
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals