CMS Price Transparency Data

Hepatitis C antibody test

Facility: Spotsylvania Regional Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $58
  • Cash Discount Price: $702
  • vs. Medicare Baseline: 4.06x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Spotsylvania Regional Medical Center is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $702. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.06x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.
Cash / Self-Pay
$702

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $702 (4919%)
Insurance Median: $58 (406%)
Cash: $702 (4919% of Medicare)
Ins. Median: $58 (406% 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 406% of the Medicare baseline (a markup of 306%). 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
Aetna $14 98%
Devoted $14 98%
Humana $14 98%
Johns Hopkins $14 98%
Sentara Health $14 98%
United $14 - $316 98%
United Behavioral Health $14 98%
Align Senior Care $15 105%
Blue Cross Blue Shield $15 - $75 105%
Cigna $15 - $71 105%
Clear Spring Health Plan $15 105%
Evernorth Behavioral Health $15 105%
Virginia Premier Health $15 105%
Bright Health $31 217%
Lifeworks $133 932%
Virginia Health Network $246 - $456 1724%
Kaiser $414 2901%
Greenvbrier Sporting Club $421 2950%
Multiplan $498 3490%
Corvel $505 3539%
Occunet Workers Comp $562 3938%
4Most Health Nework $632 4429%
Three Rivers Provider Network $632 4429%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 Spotsylvania Parkway, Fredericksburg, VA 22408
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals