CMS Price Transparency Data

Hepatitis C antibody test

Facility: Englewood Hospital and Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $37
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 2.59x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Englewood Hospital and Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.59x the Medicare baseline. Located in 350 Engle St, Englewood, NJ.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $44 (308%)
Insurance Median: $37 (259%)
Cash: $44 (308% of Medicare)
Ins. Median: $37 (259% 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 259% of the Medicare baseline (a markup of 159%). 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
Oxford_741 $5 35%
UnitedHealthcare $5 - $14 35%
Heathnet Federal Services $13 91%
Hip Health Plan $13 - $14 91%
Horizon New Jersey Health_674 $13 91%
Aetna $14 - $218 98%
Americhoice_732 $14 98%
Amerigroup_758 $14 98%
Amerihealth_766 $14 98%
Blue Cross Blue Shield $14 - $257 98%
Clover_733 $14 98%
Horizon New Jersey Health - Dsnp $14 - $19 98%
Humana $14 98%
Emblem_734 $15 105%
Emblem_762 $15 105%
Wellcare_765 $15 105%
Americhoice_756 $19 133%
Health Care Support_787 $25 175%
Amerihealth_760 $26 182%
Wellcare_755 $35 245%
Amerigroup_754 $44 308%
Magnacare_768 $53 371%
Magnacare_770 $53 371%
Amerihealth_757 $203 1423%
Multiplan $213 - $217 1493%
Cigna $238 1668%
Horizon $259 - $276 1815%
Magnacare_763 $266 1864%
Magnacare_769 $266 1864%
Qualcare_752 $293 2053%
Qualcare $297 2081%
Bergen $332 2327%
Coventry $332 2327%
Magnacare $354 2481%
Qualcare_783 $7,783 54541%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 350 Engle St, Englewood, NJ 07631
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals