CMS Price Transparency Data

Hepatitis C antibody test

Facility: Canyon Vista Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $48
  • Cash Discount Price: $80
  • vs. Medicare Baseline: 3.36x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Canyon Vista Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.36x the Medicare baseline. Located in 5700 East Highway 90, Sierra Vista, AZ.
Cash / Self-Pay
$80

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $80 (561%)
Insurance Median: $48 (336%)
Cash: $80 (561% of Medicare)
Ins. Median: $48 (336% 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 336% of the Medicare baseline (a markup of 236%). 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
University Phyicians Inc $14 98%
Veteran Family Member Program $14 98%
Aetna $15 105%
Azch-Complete Care Plan $15 105%
Humana $15 105%
UnitedHealthcare $15 - $82 105%
Luminare Health $48 336%
Meritain Health $48 336%
Government Employees Health Association $86 603%
Ameriben Solutions $110 771%
Cigna $117 820%
Blue Cross Blue Shield $128 897%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5700 East Highway 90, Sierra Vista, AZ 85635
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals