CMS Price Transparency Data

Hepatitis C antibody test

Facility: Brattleboro Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $145
Cash Discount Price: $114
vs. Medicare Baseline: 10.16x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Brattleboro Memorial Hospital is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 10.16x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$145

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: $114 (799%)

Insurance Median: $145 (1016%)

Cash: $114 (799% of Medicare)

Ins. Median: $145 (1016% 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 1016% of the Medicare baseline (a markup of 916%). 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
Blue Cross Blue Shield	$9 - $167	63%
UnitedHealthcare	$9 - $177	63%
Amerihealth-Caritas	$14	98%
Harvard Pilgrim Health Care	$14 - $162	98%
Humana	$14	98%
Martin'S Point	$14	98%
Mvp Healthcare	$14 - $167	98%
New Hampshire Healthy Families	$14	98%
Wellsense	$14 - $15	98%
Cigna	$15 - $177	105%
New Hampshire Healthy Families (Wellcare)	$15	105%
Multiplan	$16 - $180	112%
Vermont Health Plan	$21 - $166	147%
Tufts Health Plan	$33 - $170	231%
Aetna	$153 - $180	1072%
Coventry	$153 - $180	1072%
Health New England	$153 - $180	1072%

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 $114.
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 Brattleboro Memorial Hospital 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.