CMS Price Transparency Data

Hepatitis C antibody test

Facility: Charleston Area Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $209
Cash Discount Price: $239
vs. Medicare Baseline: 14.65x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Charleston Area Medical Center is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 14.65x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$239

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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: $239 (1675%)

Insurance Median: $209 (1465%)

Cash: $239 (1675% of Medicare)

Ins. Median: $209 (1465% 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 1465% of the Medicare baseline (a markup of 1365%). 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
Aetna	$13 - $244	91%
The Health Plan Of West Virginia Inc.	$13 - $242	91%
Unicare Health Plan Of West Virginia Inc.	$13	91%
Blue Cross Blue Shield	$14 - $227	98%
Choicecare Network	$14 - $244	98%
Optimum Choice Inc.	$14	98%
Triwest Va	$14	98%
UnitedHealthcare	$15 - $244	105%
West Virginia Senior Advantage Inc.	$15	105%
Integrated Medical Solutions	$28	196%
Naphcare	$29	203%
Caresource	$36	252%
Tricare	$137 - $149	960%
City Of Charleston	$172 - $187	1205%
Cigna	$213 - $232	1493%
Three Rivers Providers Network	$222 - $242	1556%
Healthsmart	$224 - $244	1570%
Multiplan	$224 - $244	1570%

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 $239.
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 Charleston Area Medical Center 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.