CMS Price Transparency Data

Hepatitis C antibody test

Facility: Northwest Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $18
  • Cash Discount Price: $182
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Northwest Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $182. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.26x the Medicare baseline. Located in 6200 North La Cholla Boulevard, Tucson, AZ.
Cash / Self-Pay
$182

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $182 (1275%)
Insurance Median: $18 (126%)
Cash: $182 (1275% of Medicare)
Ins. Median: $18 (126% 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.

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 - $272 98%
Blue Cross Blue Shield $14 - $91 98%
Cigna $14 - $23 98%
Department Of Veterans Affairs $14 98%
Fresenius Health $14 98%
Humana $14 98%
Medicaid / KanCare $14 - $15 98%
Medicare (plans) $14 98%
Node Caremore Mcr Adv $14 98%
Node Clover Health Mcr Adv $14 98%
Node Devoted Health Mcr Adv $14 98%
Node Non Par Hospice Agree $14 98%
Node Va $14 98%
Pascua Yaqui Tribe $14 98%
Scan Health Plan $14 98%
Tricare $14 98%
Triwest $14 98%
UnitedHealthcare $14 - $302 98%
Veterans Eval Services $14 98%
Magellan $15 105%
Node Banner Mcr Adv $15 105%
Wellcare $15 105%
Node Us Dept Of Labor $18 126%
Ambetter / Centene $20 140%
Node Health Choice Health Exchange $21 147%
Health Net $23 161%
Node Fusion Network $26 182%
Node J Allen Inmate Health Svcs $27 189%
Seven Corners $33 231%
Self Pay $145 - $218 1016%
First Health Coventry $318 2228%
Coventry Medical Center $363 2544%
Multiplan $502 3518%
Prime Health $514 3602%
Healthsmart $544 3812%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 North La Cholla Boulevard, Tucson, AZ 85741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals