CMS Price Transparency Data

Hepatitis C antibody test

Facility: Intermountain Health St. Mary's Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $129
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 9.04x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Intermountain Health St. Mary's Regional Hospital is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 9.04x the Medicare baseline. Located in 2635 N 7Th St, Grand Junction, CO.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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%)
Insurance Median: $129 (904%)
Ins. Median: $129 (904% 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 904% of the Medicare baseline (a markup of 804%). 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
Geha $14 - $155 98%
Select Health $14 98%
UnitedHealthcare $14 - $155 98%
Blue Cross Blue Shield $34 - $67 238%
Monument Health $86 - $88 603%
Cigna $105 - $126 736%
Allegiance $122 - $126 855%
Aetna $129 - $155 904%
Kaiser Perm Ppo/Pos $139 - $142 974%
Meritain Health $143 - $147 1002%
Humana $150 - $154 1051%
Cofinity $151 - $155 1058%
First Health Network $151 - $155 1058%
Private Hlthcare Sys $159 - $163 1114%
Public Employees Health $166 - $170 1163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2635 N 7Th St, Grand Junction, CO 81501
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals