CMS Price Transparency Data

Hepatitis C antibody test

Facility: Childrens Hospital of Wisconsin

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $133
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 9.32x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Childrens Hospital of Wisconsin is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 9.32x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$133

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: $120 (841%)
Insurance Median: $133 (932%)
Cash: $120 (841% of Medicare)
Ins. Median: $133 (932% 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 932% of the Medicare baseline (a markup of 832%). 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
My Choice Wisconsin $14 - $16 98%
UnitedHealthcare $14 - $218 98%
Chorus Community Health Plan $15 105%
Blue Cross Blue Shield $16 - $273 112%
Managed Health Services $16 112%
Molina Healthcare Of Wisconsin $16 112%
Icare $18 126%
Froedtert Health $104 - $244 729%
Medical College Of Wisconsin $104 - $201 729%
Network Health Plan $106 - $204 743%
Aspirus Health Plan $111 - $215 778%
Common Ground Healthcare Cooperative $111 - $244 778%
Trilogy Health Solutions $111 - $244 778%
Wps Health Plan $113 - $258 792%
Advocate Aurora Healthcare $114 - $221 799%
Centivo $116 - $224 813%
Employer Health Care Alliance Cooperative $116 - $225 813%
Health Partners $116 - $253 813%
Dean Health Plan $119 - $230 834%
Group Health Cooperative Of Eau Claire $119 - $230 834%
Oan Llc $119 - $230 834%
Security Health Plan $123 - $238 862%
Health Payment Systems $125 - $243 876%
Praire States $126 - $244 883%
Quartz Health Insurance $126 - $244 883%
Sheboygan Employer'S Health Network $126 - $244 883%
Mayo Clinic Health Solutions $129 - $250 904%
Aetna $130 - $255 911%
Bellin Thedacare $133 - $258 932%
Cigna $133 - $258 932%
Group Health Cooperative Of South Central Wisconsin $133 - $258 932%
Prevea Health Network $133 - $258 932%
Multiplan $135 - $273 946%
Coventry Health Care $141 - $273 988%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens