CMS Price Transparency Data

Hepatitis C antibody test

Facility: UPMC Muncy

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $240
Cash Discount Price: $280
vs. Medicare Baseline: 16.82x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at UPMC Muncy is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $280. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 16.82x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$280

Average discount available for prompt cash payment at this facility.

Insurance Median

$240

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: $280 (1962%)

Insurance Median: $240 (1682%)

Cash: $280 (1962% of Medicare)

Ins. Median: $240 (1682% 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 1682% of the Medicare baseline (a markup of 1582%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Upmc Work Partners	$14	98%
Three Rivers Provider Network	$15 - $419	105%
Amerihealth Caritas	$21 - $2,208	147%
Geisinger	$21 - $312	147%
Highmark Wholecare (Prev Gateway)	$21 - $70	147%
Upmc Health Plan	$21 - $203	147%
UnitedHealthcare	$24 - $319	168%
Pa Health & Wellness	$32 - $2,316	224%
Cigna	$73 - $319	512%
Aetna	$143 - $308	1002%
Coventry/First Health	$176 - $314	1233%
Blue Cross Blue Shield	$183 - $215	1282%
Wirerope Works	$259	1815%
Multiplan	$363 - $443	2544%
America'S Choice	$373	2614%
Intergroup	$373	2614%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $280.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Muncy is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.