CMS Price Transparency Data

Hepatitis C antibody test

Facility: Maimonides Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $18
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Maimonides Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.26x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $75 (526%)
Insurance Median: $18 (126%)
Cash: $75 (526% of Medicare)
Ins. Median: $18 (126% 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
Aetna $14 98%
Healthfirst $14 98%
United Community Plan $16 112%
Metroplus $17 119%
Oxford Health Plan $18 126%
Oxford Liberty $18 126%
UnitedHealthcare $18 126%
Local 1199 $20 140%
Cigna $34 238%
Magnacare $39 273%
Emblem Health - Ghi $43 301%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4802 Tenth Avenue, Brooklyn, NY 11219
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals