CMS Price Transparency Data

Hepatitis C antibody test

Facility: Northwest Medical Center Sahuarita

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $14
  • Cash Discount Price: $172
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Northwest Medical Center Sahuarita is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$172

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $172 (1205%)
Insurance Median: $14 (98%)
Cash: $172 (1205% of Medicare)
Ins. Median: $14 (98% 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 - $22 98%
Blue Cross Blue Shield $14 - $81 98%
Cigna $14 - $23 98%
Department Of Veterans Affairs $14 98%
Humana $14 98%
Medicaid / KanCare $14 - $15 98%
Medicare (plans) $14 98%
Mercy Care $14 98%
Node Caremore Mcr Adv $14 98%
Node Champva $14 98%
Node Clover Health Mcr Adv $14 98%
Node Devoted Health Mcr Adv $14 98%
Node Mercy Care Mcr Adv $14 98%
Node Non Par Hospice Agree $14 98%
Node Triwest $14 98%
Node Va $14 98%
Tricare $14 98%
UnitedHealthcare $14 - $17 98%
Banner Mcr Adv $15 105%
Node Banner Mcr Adv $15 105%
Node Wellcare Mcr Adv $15 105%
Node Us Dept Of Labor $18 126%
Ambetter / Centene $20 140%
Node Health Choice Health Exchange $21 147%
Node Fusion Network $26 182%
Node J Allen Inmate Health Svcs $27 189%
Self Pay $109 - $236 764%
Coventry Work Comp Al $363 2544%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals