CMS Price Transparency Data

Hepatitis C antibody test

Facility: Kings County Hospital Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $49
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Kings County Hospital Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.43x the Medicare baseline. Located in 451 Clarkson Avenue, Brooklyn, NY.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $14 (98%)
Insurance Median: $49 (343%)
Cash: $14 (98% of Medicare)
Ins. Median: $49 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
Blue Cross Blue Shield $10 - $109 70%
Healthfirst $10 - $109 70%
Aetna $11 - $42 77%
Elderplan $14 98%
Fidelis $14 - $109 98%
Centers Plan For Healthy Living $15 105%
Magnacare $17 119%
Villagecare Max $17 - $51 119%
Centerlight $18 - $30 126%
Hamaspik $18 126%
Local 1199 $20 - $51 140%
Oscar $20 - $21 140%
Oxford $21 147%
United $21 - $61 147%
Wellcare $22 - $36 154%
Affinity $25 - $109 175%
Cigna $35 245%
Carelon $39 - $48 273%
Emblem $42 - $65 294%
Metroplus $47 - $109 329%
Amidacare $48 336%
Multiplan $48 336%
Senior Whole Health $48 336%
United Behavioral Health $48 - $53 336%
Carelon (Amida Care) $49 343%
Vnsny $49 - $51 343%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 451 Clarkson Avenue, Brooklyn, NY 11203
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals