CMS Price Transparency Data

Hepatitis C antibody test

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $95
  • Cash Discount Price: $98
  • vs. Medicare Baseline: 6.66x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at University of Wi Hospitals & Clinics Authority is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.66x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$98

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $98 (687%)
Insurance Median: $95 (666%)
Cash: $98 (687% of Medicare)
Ins. Median: $95 (666% 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 666% of the Medicare baseline (a markup of 566%). 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 - $168 98%
Blue Cross Blue Shield $14 - $199 98%
Humana $14 98%
Medicare (plans) $14 - $15 98%
UnitedHealthcare $14 - $131 98%
Alliance_Premier_Network $57 - $100 399%
Mercycare $59 - $104 413%
Triology $61 - $127 427%
Security_Health_Plan $64 - $133 448%
Employer'S_Coalition_On_Health $65 - $161 456%
Alliance $67 - $118 470%
Hfn $68 - $161 477%
United_Healthcare $68 - $177 477%
Beloit_Health_System $69 - $121 484%
Aspirus_Health_Plan $70 - $122 491%
Cigna $71 - $125 498%
Health_Partners_Insurance $73 - $127 512%
Health_Payment_Systems $73 - $128 512%
Dean_Health_Plan $76 - $134 533%
Medical_Associates $79 - $138 554%
Wps $82 - $159 575%
Employers_Healthcare_Coalition_Of_Wi $83 - $146 582%
Aspirus_Network_Inc $92 - $161 645%
Chorus_Community $95 - $167 666%
Ghc_Eau_Claire_Health_Plan $95 - $167 666%
Multiplan $95 - $192 666%
Sheybogan_Employers_Health_Network $95 - $167 666%
Coventry $101 - $178 708%
Dean_Care $101 - $178 708%
Healthsmart $105 - $184 736%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals