CMS Price Transparency Data

Hepatitis C antibody test

Facility: Banner Payson Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $23
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Banner Payson Medical Center is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.61x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $19 (133%)
Insurance Median: $23 (161%)
Cash: $19 (133% of Medicare)
Ins. Median: $23 (161% 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
Arizona Physicians Ipa $14 - $21 98%
Banner University Health Plan $14 - $21 98%
Health Choice Arizona, Inc. $14 - $30 98%
Health Net $14 - $31 98%
Mercy Care $14 - $21 98%
Aetna $21 - $34 147%
Banner Health $21 147%
Blue Cross Blue Shield $21 - $67 147%
Care 1St $21 147%
Cigna $21 - $41 147%
Gila River Health Care Corporation $21 147%
Kaiser Foundation Health Plan $21 147%
Triwest Healthcare Alliance Corp - Va Ccn $21 147%
UnitedHealthcare $21 - $34 147%
Upmc Health Plan $21 147%
Wellpoint $21 147%
Carelon $22 154%
Humana $22 154%
Arizona Priority Care $23 161%
Devoted Health Services $23 161%
Gold Kidney Health Plan $23 161%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $23 161%
Plotkin Health $23 161%
Oscar Health Plan $34 238%
Quiktrip Corporation $36 252%
Arizona Medical Network $46 322%
Provider Network Of America $46 322%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 807 South Ponderosa Drive, Payson, AZ 85541
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals