CMS Price Transparency Data

Hepatitis C antibody test

Facility: Samaritan Hospital of Troy, New York

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $46
  • Cash Discount Price: $107
  • vs. Medicare Baseline: 3.22x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Samaritan Hospital of Troy, New York is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.22x the Medicare baseline. Located in 2215 Burdett Avenue, Troy, NY.
Cash / Self-Pay
$107

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $107 (750%)
Insurance Median: $46 (322%)
Cash: $107 (750% of Medicare)
Ins. Median: $46 (322% 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 322% of the Medicare baseline (a markup of 222%). 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
Albany County Correctional Facility $10 70%
Medicaid / KanCare $10 - $164 70%
Nascentia Health Options $10 70%
Blue Cross Blue Shield $11 - $65 77%
Eddy Seniorcare Pace $14 98%
Medicare (plans) $14 - $164 98%
UnitedHealthcare $14 - $164 98%
Aetna $15 - $46 105%
Hudson Headwaters Pace $15 105%
Mvp $15 105%
Secure Horizons Ma Pffs $15 105%
Nascentia Health Plus $16 112%
Fidelis Care $26 182%
Wellpath $32 224%
Harvard Pilgrim Healthcare $36 252%
Bcn Domestic $37 259%
Blue Care Network $37 259%
Unicare $37 259%
Blue Shield - Ny Highmark Northeastern $40 - $65 280%
1199 National Benefit Fund $46 322%
Allied Benefit Systems $46 322%
Asr Health Benefits $46 322%
Christian Brother Services $46 322%
Geha $46 322%
Lucent Health $46 322%
Luminare Health $46 322%
Medical Mutual $46 322%
Meritain $46 322%
Trustmark Small Business Benefits $46 322%
Blue Shield - Ca $65 456%
Blue Shield - Id (Regence) $65 456%
Blue Shield - Ny Highmark Western $65 456%
Blue Shield - Pa (Highmark) $65 456%
Blue Shield - Wa (Regence) $65 456%
Allegiance $74 519%
American Postal Workers Secondary $74 519%
Cigna $74 519%
Diversified Administrators $74 519%
Health Partners $74 519%
Priority Health $74 519%
Tufts Health Plan $74 519%
Webtpa $74 519%
Emblem Health $82 575%
Nova $82 575%
First Health $131 918%
Health Republic $139 974%
Independent Health $139 974%
Magnacare $139 974%
Health New England $148 1037%
Multiplan $148 1037%
Phcs $148 1037%
Carelon Behavioral Health $164 1149%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals