CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $39
  • Cash Discount Price: $1,770
  • vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Healthone Presbyterian St Luke's is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,770. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.73x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.
Cash / Self-Pay
$1,770

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $1,770 (12404%)
Insurance Median: $39 (273%)
Cash: $1,770 (12404% of Medicare)
Ins. Median: $39 (273% 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 273% of the Medicare baseline (a markup of 173%). 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
Cigna $9 - $1,133 63%
UnitedHealthcare $12 84%
Aetna $14 - $935 98%
Blue Cross Blue Shield $14 - $1,310 98%
Bright Health $14 - $531 98%
Devoted Health $14 98%
Humana $14 98%
Kaiser National Transplant $14 - $850 98%
Mutual Of Omaha $14 98%
Rocky Mountain Health $14 98%
Rocky Mountain Health Plan $14 98%
Total Longterm Care $14 98%
Triwest Health Alliance $14 98%
United $14 - $796 98%
Delaware Life Insurance $15 105%
Innovage Pace $15 105%
Kaiser $15 - $460 105%
Wellcare $15 105%
Pinnacol Workers Comp $39 273%
Multiplan $41 - $1,593 287%
Vail Health $269 1885%
Emerging Therapy Solutions $850 - $1,133 5957%
Colorado Program For Children With Special Needs $903 6328%
Western Plains Community Health $1,150 8059%
Northcare $1,239 8683%
Physician Health Partners $1,239 8683%
Medical Development International $1,416 9923%
Prime Health $1,593 11163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1719 E 19Th Ave, Denver, CO 80218
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals