CMS Price Transparency Data
Hepatitis C antibody test
Facility: Mount Carmel New Albany Surgical Hospital
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $21
- Cash Discount Price: $29
- vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mount Carmel New Albany Surgical Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.47x the Medicare baseline. Located in 7333 Smith's Mill Road, New Albany, OH.
Cash / Self-Pay
$29
Average discount available for prompt cash payment at this facility.
Insurance Median
$21
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: $29 (203%)
Insurance Median: $21 (147%)
Cash: $29 (203% of Medicare)
Ins. Median: $21 (147% 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.
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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 | $13 - $45 | 91% |
| Medicare (plans) | $13 - $15 | 91% |
| Rural Carrier Health Benefit Plan | $13 | 91% |
| Blue Benefit Administrators Of Massachusetts | $14 | 98% |
| Blue Care Network | $14 | 98% |
| Blue Cross Blue Shield | $14 - $45 | 98% |
| Blue Distinction Transplant | $14 | 98% |
| Blue Shield - Ca | $14 | 98% |
| Blue Shield - Id (Regence) | $14 | 98% |
| Blue Shield - Ny Highmark Northeastern | $14 | 98% |
| Blue Shield - Ny Highmark Western | $14 | 98% |
| Blue Shield - Pa (Highmark) | $14 | 98% |
| Blue Shield - Wa (Regence) | $14 | 98% |
| Hospice Mount Carmel | $14 | 98% |
| Oscar | $14 | 98% |
| UnitedHealthcare | $14 - $69 | 98% |
| The Health Plan | $15 - $30 | 105% |
| Geha | $20 - $69 | 140% |
| Gravie Admin Services | $20 | 140% |
| Healthez | $20 | 140% |
| Meritain | $20 | 140% |
| Webtpa | $20 | 140% |
| Access Health | $21 | 147% |
| Acclaim | $21 | 147% |
| Administrative Concepts | $21 | 147% |
| Allegeant | $21 | 147% |
| Allied Benefit Systems | $21 | 147% |
| American Family | $21 | 147% |
| American Healthcare Alliance | $21 | 147% |
| American National | $21 | 147% |
| American Republic | $21 | 147% |
| Amerihealth | $21 | 147% |
| Aultcare | $21 | 147% |
| Automated Benefit Services | $21 | 147% |
| Auxiant | $21 | 147% |
| Benefit Administrative Systems,Llc | $21 | 147% |
| Boon Chapman | $21 | 147% |
| Cam Administrative Services | $21 | 147% |
| Christian Brother Services | $21 | 147% |
| Christian Brothers Holy Cross | $21 | 147% |
| Claimchoice Adminstrators | $21 | 147% |
| Comprehensive Benefits | $21 | 147% |
| Continental Life Insurance | $21 | 147% |
| Coventry | $21 | 147% |
| Custom Benefit Administrators | $21 | 147% |
| Cypress Benefit Administrators | $21 | 147% |
| Employee Benefit Concepts | $21 | 147% |
| Employee Benefit Management | $21 | 147% |
| Forest County Potawatomi | $21 | 147% |
| Freedom Life Insurance Company | $21 | 147% |
| Group Administrators | $21 | 147% |
| Group Marketing Services | $21 | 147% |
| Group Pension Administrators | $21 | 147% |
| Guardian | $21 | 147% |
| Health America | $21 | 147% |
| Health Choices | $21 | 147% |
| Healthcare Management Admin | $21 | 147% |
| Insight | $21 | 147% |
| Intercare | $21 | 147% |
| Jfp Benefit Management | $21 | 147% |
| Jp Farley Corporation | $21 | 147% |
| Key Benefit Administrator | $21 | 147% |
| Liberty Union Life Assurance Co | $21 | 147% |
| Lucent Health | $21 | 147% |
| Luminare Health | $21 | 147% |
| Magnacare | $21 | 147% |
| Medcost | $21 | 147% |
| Mutual Health Services | $21 | 147% |
| Mutual Of Omaha | $21 | 147% |
| Ncas | $21 | 147% |
| Nippon Life Ins | $21 | 147% |
| Nova | $21 | 147% |
| Painters Union Insurance Fund | $21 | 147% |
| Physicians Mutual | $21 | 147% |
| Plumbers Local 98 Insurance Fund | $21 | 147% |
| Prairie States | $21 | 147% |
| Preferred One | $21 | 147% |
| Primary Physician Care | $21 | 147% |
| Professional Benefit Administrators | $21 | 147% |
| Secureone Preferred United Plans | $21 | 147% |
| Siho Insurance Services | $21 | 147% |
| Sisco Benefits | $21 | 147% |
| The Loomis Company | $21 | 147% |
| Trustmark Small Business Benefits | $21 | 147% |
| U Of M Health Plan | $21 | 147% |
| Unicare | $21 | 147% |
| Unified Group Services | $21 | 147% |
| Us Health And Life | $21 | 147% |
| Valenz | $21 | 147% |
| Varipro | $21 | 147% |
| Wps | $21 | 147% |
| Humana | $23 - $45 | 161% |
| First Health | $24 | 168% |
| Medical Mutual | $26 - $38 | 182% |
| Medben | $27 - $34 | 189% |
| Consociate | $28 | 196% |
| Enterprise Group Planning | $28 | 196% |
| Health Ohio Network | $28 | 196% |
| Custom Design Benefits | $30 | 210% |
| Quality Care Partners | $32 | 224% |
| Caresource | $33 | 231% |
| Healthlink Inc | $34 | 238% |
| Medical Benefits Mutual | $34 | 238% |
| Ohio Health Choice | $34 | 238% |
| Ohio Ppo Connect | $34 | 238% |
| Ameriben | $36 | 252% |
| Luminare Health (Detroit) | $36 | 252% |
| Medi Share | $36 | 252% |
| Multiplan | $36 | 252% |
| Ohiohealthy | $36 | 252% |
| Osu Not Independent Choice | $36 | 252% |
| Phcs | $36 | 252% |
| Philadelphia American Life Insurance | $36 | 252% |
| Twin Valley Psychiatric | $36 | 252% |
| Health Smart | $38 | 266% |
| Western & Southern Financial Group | $38 | 266% |
| Bccp | $45 | 315% |
| Medicaid / KanCare | $45 | 315% |
| Optima Health | $45 | 315% |
| American Postal Workers Secondary | $59 | 413% |
| Cigna | $59 | 413% |
| Health Partners | $59 | 413% |
| Healthgram | $59 | 413% |
| Mvp | $59 | 413% |
| Priority Health | $59 | 413% |
| Crime Victim Assistance | $632 | 4429% |
| Ohio Safe Program | $632 | 4429% |