CMS Price Transparency Data

Hepatitis C antibody test

Facility: Saint Joseph Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $149
Cash Discount Price: Unavailable
vs. Medicare Baseline: 10.44x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Saint Joseph Hospital is $149. 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 10.44x the Medicare baseline. Located in 1375 E 19Th Ave, Denver, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $149 (1044%)

Ins. Median: $149 (1044% 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 1044% of the Medicare baseline (a markup of 944%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $374	63%
Geha	$14 - $217	98%
Select Health	$14	98%
UnitedHealthcare	$14 - $217	98%
Blue Cross Blue Shield	$25 - $304	175%
Denv Hlth Med Plan	$37	259%
Kaiser Perm Hmo	$54 - $158	378%
Kaiser Self Funded	$67 - $158	470%
Kaiser Perm Ppo/Pos	$68 - $162	477%
Allegiance	$73 - $94	512%
Kaiser Mrp	$73 - $94	512%
Kaiser Snp	$73 - $94	512%
Aetna	$108 - $336	757%
Preferred One	$116 - $149	813%
Humana	$122 - $157	855%
Cofinity	$210 - $270	1472%
First Health Network	$210 - $270	1472%
Private Hlthcare Sys	$218 - $281	1528%
Multiplan Inc	$244 - $314	1710%
Midlands Choice	$282 - $363	1976%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Saint Joseph Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.