CMS Price Transparency Data

Hepatitis C antibody test

Facility: Boulder Community Health

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $139
  • Cash Discount Price: $183
  • vs. Medicare Baseline: 9.74x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Boulder Community Health is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 9.74x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$183

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

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: $183 (1282%)
Insurance Median: $139 (974%)
Cash: $183 (1282% of Medicare)
Ins. Median: $139 (974% 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 974% of the Medicare baseline (a markup of 874%). 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
UnitedHealthcare $5 - $15 35%
Blue Cross Blue Shield $6 - $218 42%
Humana $10 - $14 70%
Aetna $11 - $319 77%
Health Spring $11 77%
Medicare (plans) $12 - $139 84%
Select Health Colorado Public Option $12 - $139 84%
Select Health Value Network $12 - $139 84%
Devoted Health $14 - $146 98%
Clear Spring $15 105%
Rocky Mountain Health Maintenance Organization $15 105%
Cigna $16 - $293 112%
Multiplan $22 - $256 154%
Phcs $22 - $256 154%
Kaiser Public Option $27 189%
Kaiser $33 231%
Kaiser Ppo $34 238%
Rocky Mountain Health Maintenance Organization Private Plan $256 1794%
Integrated Health Plans Bch $274 1920%
Casualty Management Network, Prime Health Services Behavioral Health $311 2179%
Mines And Associates $311 2179%
Three Rivers Provider Network $311 2179%
Zelis (Profee) $311 2179%
Casualty Management Network, Prime Health Services Community Medical Associates $329 2306%
National Preferred Provider Network $329 2306%
Rockport Healthcare Group Community Medical Associates $329 2306%
Usa $329 2306%
Rockport Healthcare Group Bch $340 2383%
Health Payors Organization $348 2439%
Health Management Network Bch Community Medical Associates $351 2460%
Health Management Network Community Medical Associates $351 2460%
National Provider Network $355 2488%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals