CMS Price Transparency Data

Hepatitis C antibody test

Facility: Atlantic Rehabilitation Institute, LLC

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $161
  • Cash Discount Price: $161
  • vs. Medicare Baseline: 11.28x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Atlantic Rehabilitation Institute, LLC is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 11.28x the Medicare baseline. Located in 200 Madison Ave, Madison, NJ.
Cash / Self-Pay
$161

Average discount available for prompt cash payment at this facility.

Insurance Median
$161

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: $161 (1128%)
Insurance Median: $161 (1128%)
Cash: $161 (1128% of Medicare)
Ins. Median: $161 (1128% 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 1128% of the Medicare baseline (a markup of 1028%). 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 $161 1128%
All Savers Cpd $161 1128%
Ama Insurance Msg $161 1128%
Ambetter / Centene $161 1128%
Amerigroup Mgg (Wellpoint As Of 5/1/24) $161 1128%
Amerihealth Cpd $161 1128%
Amerihealth Mgg $161 1128%
Blue Cross Blue Shield $161 1128%
Braven Health Cpd $161 1128%
Braven Health Mgd $161 1128%
Cigna $161 1128%
Claim Doc Llc Cpd $161 1128%
First Managed Care Wc Cpd $161 1128%
Gateway Mgg $161 1128%
Medicaid / KanCare $161 1128%
Oscar Health Cpd $161 1128%
Oxford Health Plan Cpd $161 1128%
Oxford Mgg $161 1128%
Qualcare Cpd $161 1128%
Qualcare Lynx Wc Cpd $161 1128%
UnitedHealthcare $161 1128%
Upmc For Life Mgg $161 1128%
Wellcare Mgg $161 1128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Madison Ave, Madison, NJ 07940
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL