CMS Price Transparency Data

Hepatitis C antibody test

Facility: Montefiore New Rochelle Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $10
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Montefiore New Rochelle Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.70x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $170 (1191%)
Insurance Median: $10 (70%)
Cash: $170 (1191% of Medicare)
Ins. Median: $10 (70% 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.

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
Centerlight $10 70%
Emblem $10 - $209 70%
Empire $10 - $209 70%
Fidelis $10 - $12 70%
Healthfirst $10 70%
Medicaid / KanCare $10 70%
Metroplus $10 - $18 70%
Molina Healthcare Of Ny Affinity $10 - $22 70%
Mvp $10 - $21 70%
UnitedHealthcare $10 - $29 70%
Villagecaremax $10 70%
Vnsny Choice $10 - $12 70%
Wellcare $10 70%
Amidacare $11 77%
Hamaspik $11 77%
Humana $11 77%
Partners_Health_Plan $11 77%
Vnsny Select Health $12 84%
Oscar $14 98%
Aetna $64 - $71 448%
Cigna $136 953%
Centivo $164 1149%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16 Guion Place, New Rochelle, NY 10802
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals