CMS Price Transparency Data

Hepatitis C antibody test

Facility: Riverview Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $103
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 7.22x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Riverview Medical Center is $103. 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 7.22x the Medicare baseline. Located in One Riverview Plaza, Red Bank, NJ.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $103 (722%)
Cash: $14 (98% of Medicare)
Ins. Median: $103 (722% 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 722% of the Medicare baseline (a markup of 622%). 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 $6 - $1,930 42%
Blue Cross Blue Shield $10 - $468 70%
Horizon $10 - $1,732 70%
Amerigroup $14 98%
Clover $14 98%
Seoul Medical Group $14 98%
Vaccn $14 98%
Wellcare $14 98%
United Community/Americhoice $15 105%
UnitedHealthcare $17 - $1,263 119%
Karna $19 133%
Qualcare $22 - $1,888 154%
Oxford $29 203%
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%
Multiplan - PHCS $37 - $1,823 259%
Amerihealth $38 - $2,101 266%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Riverview Plaza, Red Bank, NJ 07701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals