CMS Price Transparency Data

Hepatitis C antibody test

Facility: St Luke's Hospital - Upper Bucks Campus

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $38
  • Cash Discount Price: $296
  • vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St Luke's Hospital - Upper Bucks Campus is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $296. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.66x the Medicare baseline. Located in 3000 St. Luke's Drive, Quakertown, PA.
Cash / Self-Pay
$296

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $296 (2074%)
Insurance Median: $38 (266%)
Cash: $296 (2074% of Medicare)
Ins. Median: $38 (266% 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 266% of the Medicare baseline (a markup of 166%). 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 $14 - $272 98%
Highmark $14 - $49 98%
Aetna $15 - $57 105%
Geisinger $15 - $93 105%
Humana $15 105%
UnitedHealthcare $15 - $50 105%
Upmc Health Plan $15 - $90 105%
Keystone First $19 133%
Amerihealth Caritas $23 161%
Highmark Wholecare $23 161%
Jefferson Health Plan $27 189%
Oscar $85 596%
Cigna $90 631%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 St. Luke's Drive, Quakertown, PA 18951
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals