CMS Price Transparency Data

Hepatitis C antibody test

Facility: Bellevue Hospital Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $48
Cash Discount Price: $14
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Bellevue Hospital Center is $48. 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 3.36x the Medicare baseline. Located in 462 First Avenue, New York, NY.

Cash / Self-Pay

$14

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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: $48 (336%)

Cash: $14 (98% of Medicare)

Ins. Median: $48 (336% 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 336% of the Medicare baseline (a markup of 236%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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%
Centerlight	$14 - $18	98%
Elderplan	$14	98%
Fidelis	$14 - $109	98%
Hamaspik	$14 - $18	98%
Metroplus	$14 - $109	98%
Centers Plan For Healthy Living	$15	105%
Oxford	$15 - $21	105%
Wellcare	$15 - $22	105%
Magnacare	$17	119%
Villagecare Max	$17 - $51	119%
Local 1199	$20 - $51	140%
Oscar	$20 - $21	140%
United	$21 - $60	147%
Affinity	$25 - $109	175%
Cigna	$35	245%
Carelon	$39 - $48	273%
Emblem	$42 - $65	294%
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

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $14.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Bellevue Hospital Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.