CMS Price Transparency Data

Hepatitis C antibody test

Facility: Licking Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $329
  • Cash Discount Price: $457
  • vs. Medicare Baseline: 23.06x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Licking Memorial Hospital is $329. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $457. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 23.06x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$457

Average discount available for prompt cash payment at this facility.

Insurance Median
$329

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: $457 (3203%)
Insurance Median: $329 (2306%)
Cash: $457 (3203% of Medicare)
Ins. Median: $329 (2306% 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 2306% of the Medicare baseline (a markup of 2206%). 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
Aetna $14 - $332 98%
Blue Cross Blue Shield $14 - $392 98%
Champva [500001] $14 - $46 98%
Cigna $14 - $411 98%
Humana $14 - $443 98%
Medicare (plans) $14 - $46 98%
Tricare $14 - $45 98%
UnitedHealthcare $14 - $388 98%
Veterans Administration [100068] $14 - $46 98%
Wellcare By Allwell [450104] $14 - $46 98%
Molina Marketplace [100106] $23 - $74 161%
Medical Mutual [100114] $251 - $379 1759%
Medben [700068] $320 - $448 2242%
Allied Benefit Systems [100015] $329 2306%
Geha [100039] $329 2306%
Gravie Administrative Services [100165] $329 2306%
Meritain [100063] $329 2306%
Optima [700069] $329 2306%
Trustmark Small Business Benefits [100263] $329 2306%
Webtpa [100127] $329 2306%
Benicomp [70090] $342 2397%
Consociate Health 6 Degrees [100059] $365 2558%
Consociate Health [100029] $365 2558%
Healthscope [100157] $388 2719%
Surest [100016] $388 2719%
United Medical Resources [700071] $388 2719%
American Postal Workers [100089] $411 2880%
Antidote Health Plan Of Ohio [70006803] $411 2880%
Coresource [100002] $411 - $457 2880%
Great West Life [700064] $411 2880%
National Association Of Letter Carriers [100067] $411 2880%
Ohio Healthy Luminare Health [100264] $411 2880%
Ohio Healthy [100255] $411 2880%
Ohio Ppo Connect [70006801] $411 2880%
Osu Prime Care [100254] $411 2880%
Quality Care Partners [70006802] $411 2880%
The Health Plan [100261] $411 2880%
Wellfleet Group, Llc [100164] $411 2880%
Coventry [100010] $421 2950%
Pan American Life [700070] $421 2950%
Ohio Health Choice [100109] $438 3069%
Administrative Concepts [100006] $443 3104%
Carefactor [100087] $443 3104%
Philadelphia American Life [100260] $443 - $457 3104%
Reliance Standard-Asrm [100258] $443 3104%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals