CMS Price Transparency Data

Hepatitis C antibody test

Facility: Jfk University Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $104
Cash Discount Price: $14
vs. Medicare Baseline: 7.29x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Jfk University Medical Center is $104. 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 7.29x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$14

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $104 (729%)

Cash: $14 (98% of Medicare)

Ins. Median: $104 (729% 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 729% of the Medicare baseline (a markup of 629%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$7 - $1,802	49%
Horizon	$8 - $1,993	56%
Blue Cross Blue Shield	$14	98%
Seoul Medical Group	$14	98%
Clover	$14 - $15	98%
Amerigroup	$14	98%
Vaccn	$14	98%
Wellcare	$14	98%
United Community/Americhoice	$15	105%
Karna	$19	133%
UnitedHealthcare	$21 - $31	147%
Oxford	$31	217%
Activecare First McO	$31 - $1,502	217%
Intergroup	$31 - $1,502	217%
Bergen Risk	$33 - $1,609	231%
Qualcare	$34 - $1,737	238%
Brighton Health Plan	$35 - $1,930	245%
Prime Health	$35 - $1,716	245%
Multiplan - PHCS	$37 - $1,823	259%
Amerihealth	$42 - $2,029	294%
Cigna	$67	470%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $14.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Jfk University Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.