CMS Price Transparency Data

Hepatitis C antibody test

Facility: Lovelace Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $293
Cash Discount Price: $98
vs. Medicare Baseline: 20.53x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Lovelace Medical Center is $293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 20.53x the Medicare baseline. Located in 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$293

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: $98 (687%)

Insurance Median: $293 (2053%)

Cash: $98 (687% of Medicare)

Ins. Median: $293 (2053% 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 2053% of the Medicare baseline (a markup of 1953%). 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
The Health Plan [2915]	$66	463%
Healthscope Benefits [2290]	$83	582%
UnitedHealthcare	$83	582%
Benefit Management [1175]	$163	1142%
Magellan Behavioral Commercial [2895]	$163	1142%
Presbyterian Health Plan [1830]	$163	1142%
Zelis [2385]	$163	1142%
Administrative Concepts [1005]	$293	2053%
Aetna	$293	2053%
Allied Benefit Systems Inc [1030]	$293	2053%
Allied National Global Care [1035]	$293	2053%
American Medical Security [2190]	$293	2053%
Boon-Chapman [2375]	$293	2053%
Coresource [1315]	$293	2053%
Coventry Healthcare [1320]	$293	2053%
Emblem Health [2430]	$293	2053%
Employee Benefit Management Services [2445]	$293	2053%
Healthcost Solutions [2415]	$293	2053%
Multiplan [1680]	$293	2053%
Mutual Of Omaha [1685]	$293	2053%
National Telephone Cooperative [1700]	$293	2053%
Northamerica Administrators [1725]	$293	2053%
Pan American Life Insurance Co [1770]	$293	2053%
Phcs [1780]	$293	2053%
Trustmark [2030]	$293	2053%

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 $98.
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 Lovelace 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.