CMS Price Transparency Data

Hepatitis C antibody test

Facility: Montefiore St Luke's Cornwall

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $22
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Montefiore St Luke's Cornwall is $22. 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 1.54x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $22 (154%)
Ins. Median: $22 (154% 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
Fidelis $8 - $12 56%
Aetna $10 - $22 70%
Blue Cross Blue Shield $10 - $619 70%
Cdphp $10 70%
Centerlight $10 70%
Emblem $10 - $628 70%
Hudson Valley $10 70%
Mediblue $10 70%
Medicaid / KanCare $10 70%
Oscar $10 70%
Point Comfort $10 70%
UnitedHealthcare $10 - $17 70%
Humana $11 77%
Mvp $14 98%
American Postal Workers $17 119%
Geha $22 154%
Meritain Health $22 154%
Nippon Life Insurance $22 154%
Healthfirst $27 189%
Northwell $27 189%
Cigna $139 - $155 974%
Centivo $495 3469%
Seiu1199 $589 4128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 70 Dubois Street, Newburgh, NY 12550
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals