CMS Price Transparency Data

Hepatitis C antibody test

Facility: Metropolitan Hospital Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $30
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Metropolitan Hospital Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.10x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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%)
Insurance Median: $30 (210%)
Ins. Median: $30 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Healthfirst $10 - $63 70%
Aetna $11 - $42 77%
Elderplan $14 98%
Fidelis $14 - $63 98%
Magnacare $17 119%
Oscar $21 147%
Oxford $21 147%
United $21 - $35 147%
Metroplus $27 - $63 189%
Affinity $28 - $63 196%
Amidacare $28 196%
Blue Cross Blue Shield $28 - $63 196%
Carelon $28 - $39 196%
Carelon (Amida Care) $28 196%
Senior Whole Health $28 196%
United Behavioral Health $28 - $31 196%
Vnsny $28 - $51 196%
Centerlight $30 210%
Cigna $35 245%
Emblem $35 - $48 245%
Wellcare $36 252%
Multiplan $48 336%
Local 1199 $51 357%
Villagecare Max $51 357%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals