CMS Price Transparency Data

Hepatitis C antibody test

Facility: The University Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $138
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 9.67x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at The University Hospital is $138. 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 9.67x the Medicare baseline. Located in 150 Bergen St, Newark, NJ.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $138 (967%)
Cash: $16 (112% of Medicare)
Ins. Median: $138 (967% 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 967% of the Medicare baseline (a markup of 867%). 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
Fidelis $11 - $14 77%
UnitedHealthcare $11 - $14 77%
Aetna $14 - $138 98%
Amerihealth $14 - $20 98%
Clover Health $14 98%
Horizon $41 - $139 287%
Wellpoint $109 764%
First Health $255 1787%
Americare $273 1913%
Qualcare $273 1913%
Correctional Medical Services $291 2039%
Multiplan $291 2039%
First Trenton $328 2299%
Managed Care Inc $328 2299%
Consumer Health Network $346 2425%
Three Rivers $346 2425%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 150 Bergen St, Newark, NJ 07103
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals