CMS Price Transparency Data

Hepatitis C antibody test

Facility: Centura Health-Penrose St Francis Health Services

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $23
Cash Discount Price: $74
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Centura Health-Penrose St Francis Health Services is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.61x the Medicare baseline. Located in 2222 N Nevada Ave, Colorado Springs, CO.

Cash / Self-Pay

$74

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: $74 (519%)

Insurance Median: $23 (161%)

Cash: $74 (519% 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.

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
Aetna	$14 - $31	98%
Blue Cross Blue Shield	$14 - $46	98%
Cigna	$14 - $19	98%
Devoted Health	$14	98%
Humana	$14	98%
Innovage	$14	98%
Kaiser	$14 - $84	98%
Medicare (plans)	$14	98%
Rocky Mountain Pace	$14	98%
UnitedHealthcare	$14 - $21	98%
Centura Employee Plan	$18	126%
United Colorado Doctor'S Plan	$21	147%
Direct To Employer	$25 - $74	175%
Denver Health	$44	308%
Multiplan	$130 - $157	911%

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 $74.
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 Centura Health-Penrose St Francis Health Services 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.