CMS Price Transparency Data

Hepatitis C antibody test

Facility: Banner - University Medical Center Phoenix

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $25
Cash Discount Price: $42
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Banner - University Medical Center Phoenix is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.75x the Medicare baseline. Located in 1111 East McDowell Road, Phoenix, AZ.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

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: $42 (294%)

Insurance Median: $25 (175%)

Cash: $42 (294% of Medicare)

Ins. Median: $25 (175% 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.

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	$14 - $134	98%
Arizona Physicians Ipa	$14	98%
Banner Health	$14	98%
Banner University Health Plan	$14	98%
Blue Cross Blue Shield	$14 - $65	98%
Care 1St	$14	98%
Cigna	$14 - $28	98%
Gila River Health Care Corporation	$14	98%
Health Choice Arizona, Inc.	$14 - $21	98%
Health Net	$14 - $21	98%
Kaiser Foundation Health Plan	$14	98%
Mercy Care	$14	98%
Triwest Healthcare Alliance Corp - Va Ccn	$14	98%
UnitedHealthcare	$14 - $32	98%
Upmc Health Plan	$14	98%
Wellpoint	$14	98%
Carelon	$15	105%
Devoted Health Services	$15	105%
Humana	$15	105%
Arizona Priority Care	$16	112%
Gold Kidney Health Plan	$16	112%
Naphcare	$19	133%
Oscar Health Plan	$24	168%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$83 - $115	582%
Plotkin Health	$83 - $115	582%
Quiktrip Corporation	$100 - $138	701%
Arizona Medical Network	$130 - $178	911%
Provider Network Of America	$139 - $191	974%

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 $42.
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 Banner - University Medical Center Phoenix 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.