CMS Price Transparency Data

Hepatitis C antibody test

Facility: Lancaster General Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $62
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 4.34x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Lancaster General Hospital is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.34x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $100 (701%)
Insurance Median: $62 (434%)
Cash: $100 (701% of Medicare)
Ins. Median: $62 (434% 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 434% of the Medicare baseline (a markup of 334%). 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
Tricare $12 84%
Aetna $14 - $62 98%
Albright Life $14 98%
Blue Cross Blue Shield $14 - $88 98%
Coatesville Va $14 98%
Highmark $14 - $103 98%
Hospice And Community Care $14 - $20 98%
Hospice Generic $14 98%
Lebanon Veterans Hospital $14 98%
Medicare (plans) $14 - $16 98%
UnitedHealthcare $14 - $88 98%
Amerihealth Caritas $15 - $19 105%
Cigna $15 - $86 105%
Devoted Health $15 105%
Health Partners Mcr Advantage $15 105%
Pa Health And Wellness Mcr $15 105%
Lancaster County Mh $19 133%
Medicaid / KanCare $19 - $31 133%
Elap Employees $20 140%
Old Order Group $20 - $33 140%
Lg Coresource/Lg Eliance $21 - $29 147%
Gateway $22 154%
Lancashire Hall $22 - $103 154%
Nursing Home Op Services $22 - $31 154%
Highmark Commercial Preferred $23 - $103 161%
Oscar Health Plan $28 196%
Affilia Home Health $29 - $103 203%
Masonic Homes $31 - $103 217%
Upmc For You $32 224%
Eliance Health Solutions $33 - $66 231%
Highmark Commercial Non-Preferred $35 - $103 245%
Claim Watcher Plus $43 301%
Preferred Healthcare $44 - $88 308%
Claim Watcher $47 329%
Elap Other Groups $52 364%
Ehp $60 - $84 420%
Upmc Commercial $60 - $88 420%
Devon $62 - $88 434%
Geisinger Commercial $62 - $88 434%
Intergroup Services $62 - $88 434%
Medi-Share Christian Care $69 - $98 484%
Commercial Generic $73 - $103 512%
Magellan $73 - $103 512%
United Behavioral Health $73 - $103 512%
Value Options $73 - $103 512%
Workers Compensation $73 - $103 512%
Gift Of Life Donor Program $13,500 94604%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals