CMS Price Transparency Data

Hepatitis C antibody test

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $172
  • Cash Discount Price: $172
  • vs. Medicare Baseline: 12.05x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Rehabilitation Hospital of Wisconsin is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 12.05x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$172

Average discount available for prompt cash payment at this facility.

Insurance Median
$172

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: $172 (1205%)
Insurance Median: $172 (1205%)
Cash: $172 (1205% of Medicare)
Ins. Median: $172 (1205% 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 1205% of the Medicare baseline (a markup of 1105%). 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
Alliance Ppo $118 827%
Dean Ppo Hmo/Pos $118 827%
Medica (Under Dean) $118 827%
UnitedHealthcare $120 - $172 841%
Trilogy Ppo $124 - $172 869%
Wps "Insurance" Ppo $125 876%
Phcs Savility $129 904%
Hps Solutions Ppo $130 911%
Aetna $134 - $172 939%
Health Eos Poc $137 960%
Coventry/First Health Ppo $141 988%
Hps (Other) $141 988%
Health Eos Multiplan $146 1023%
Phcs / Multiplan $158 1107%
All Savers $172 1205%
Blue Cross Blue Shield $172 1205%
Centivo Broad $172 1205%
Centivo Intermediate/Median $172 1205%
Centivo Narrow/Value $172 1205%
Children'S Communty Health Plan(Cchp) $172 1205%
Cigna $172 1205%
Community Care, Inc $172 1205%
Humana $172 1205%
Icare Mcd $172 1205%
Managed Health Services (Mhs) $172 1205%
Medicaid / KanCare $172 1205%
Medicare (plans) $172 1205%
Molina (Fka Care Wisconsin) $172 1205%
Network Health - Aca $172 1205%
Network Health - Commercial $172 1205%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $172 1205%
Security Health Plan - Advocare $172 1205%
Together With Cchp $172 1205%
Unity Health Plan And Unity Quartz(Hmo/Pos) $172 1205%
Va - Primary Only - Authorization Required $172 1205%
Wellcare Mcr $172 1205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL