CMS Price Transparency Data

Hepatitis C antibody test

Facility: Hospital of Univ of Pennsylvania

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $105
  • Cash Discount Price: $479
  • vs. Medicare Baseline: 7.36x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Hospital of Univ of Pennsylvania is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $479. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 7.36x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$479

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $479 (3357%)
Insurance Median: $105 (736%)
Cash: $479 (3357% of Medicare)
Ins. Median: $105 (736% 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 736% of the Medicare baseline (a markup of 636%). 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
Gspp And Wissahickon Hospice $7 49%
Cigna $9 - $216 63%
UnitedHealthcare $13 - $479 91%
Blue Cross Blue Shield $14 - $338 98%
Kaiser Permanente $14 - $479 98%
Medicare (plans) $14 - $15 98%
Philadelphia Va Medical Center $14 98%
Upmc $14 - $479 98%
Aetna $15 - $479 105%
Clover Health Plan $15 105%
Devoted Health $15 105%
Geisinger Health Plan $15 - $45 105%
Health Partners $15 - $479 105%
Humana $15 - $383 105%
Ibc $15 105%
Pa Health And Wellness $15 - $24 105%
Penn Life (Living Independently For Elders) $15 105%
Keystone First $16 112%
Tricare $16 112%
Us Family Health Plan $16 112%
Gateway Health Plan $18 126%
Medicaid / KanCare $19 - $479 133%
Pa Medical Assistance $19 - $479 133%
Elap $20 140%
Ibc Commercial Hpn $22 154%
Claims Watcher $23 - $26 161%
Keystone Hmo Proactive $23 161%
Keystone Mercy Health Plan $24 - $479 168%
Oscar Health Plan $24 168%
Centivo $26 182%
Elap Services $27 189%
Highmark $30 210%
Paired Kidney Exchange $38 266%
Penn Global Medicine $38 266%
Horizon Nj Health $81 - $84 568%
Preferred Health Care Eliance $105 736%
Pgm - Regie De L'Assurance Maladie Quebec $110 771%
Pgm - Kuwait Defense $168 - $216 1177%
Qualcare $182 1275%
Olympus $188 1317%
Coventry $192 - $244 1345%
Pgm - Chop $192 1345%
Wissahickon Hospice $192 1345%
Healthamerica/Coventry $216 - $235 1514%
First Health Global $240 1682%
Health Net $287 2011%
Pgm - Royal Embassy Of Saudi Arabia $287 2011%
Pgm - Embassy Of Qatar $311 2179%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $311 2179%
Interlink $321 2249%
Pgm - Embassy Of The United Emirates/Ipc $335 2348%
Health America/Ccn $383 2684%
Intergroup $383 2684%
Pgm - Kuwait Health Division $383 2684%
Pgm - Kuwait Oil $383 2684%
Preferred Care $383 2684%
Blue Quality Centers For Transplant (Bqct) $479 3357%
City Of Philadelphia Behavioral Health $479 3357%
Commercial Other $479 3357%
International Pfs $479 3357%
United Behavioral Health $479 3357%
Workers Compensation $479 3357%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals