CMS Price Transparency Data

Hepatitis C antibody test

Facility: Chester County Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $45
  • Cash Discount Price: $196
  • vs. Medicare Baseline: 3.15x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Chester County Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.15x the Medicare baseline. Located in 701 East Marshall Street, West Chester, PA.
Cash / Self-Pay
$196

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $196 (1374%)
Insurance Median: $45 (315%)
Cash: $196 (1374% of Medicare)
Ins. Median: $45 (315% 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 315% of the Medicare baseline (a markup of 215%). 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
Cigna $9 - $196 63%
Hospice Vna $14 98%
Medicare (plans) $14 - $15 98%
Primecare Medical $14 98%
UnitedHealthcare $14 - $56 98%
Va Medical Center $14 98%
Aetna $15 - $116 105%
Clover Health Plan $15 105%
Devoted Health $15 105%
Health Partners $15 - $196 105%
Humana $15 105%
Pa Health And Wellness $15 - $24 105%
Keystone First Vip Choice $16 112%
Mva Insurance $16 112%
Tricare $16 112%
Us Family Health Plan $16 112%
Gateway $18 - $19 126%
Medicaid / KanCare $19 - $196 133%
Elap $20 140%
Claims Watcher $23 - $26 161%
Keystone First $24 168%
Oscar Health Plan $24 168%
Healthamerica/Coventry $25 175%
Centivo $26 182%
Elap Services $27 189%
Highmark $29 203%
Penn Global Medicine $38 266%
Geisinger Health Plan $45 315%
Pgm - Regie De L'Assurance Maladie Quebec $45 315%
Todays Option $55 385%
Preferred Health Care Eliance $61 427%
Ibc $65 - $151 456%
Keystone Hmo Proactive $65 456%
Pgm - Kuwait Defense $69 - $88 484%
Qualcare $74 519%
Pgm - Chop $78 547%
Pgm - Royal Embassy Of Saudi Arabia $118 827%
Pgm - Embassy Of Qatar $127 890%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $127 890%
Pgm - Embassy Of The United Emirates/Ipc $137 960%
Pgm - Kuwait Health Division $157 1100%
Pgm - Kuwait Oil $157 1100%
Preferred Health Care $157 1100%
Intergroup $167 1170%
Olympus $172 1205%
International Pfs $196 1374%
Medrisk $196 1374%
Not Adjusted $196 1374%
Workers Compensation $196 1374%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 East Marshall Street, West Chester, PA 19380
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals