CMS Price Transparency Data

Hepatitis C antibody test

Facility: Hca-Healthone DBA Swedish Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $125
  • Cash Discount Price: $418
  • vs. Medicare Baseline: 8.76x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Hca-Healthone DBA Swedish Medical Center is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $418. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.76x the Medicare baseline. Located in 501 E Hampden Ave, Englewood, CO.
Cash / Self-Pay
$418

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $418 (2929%)
Insurance Median: $125 (876%)
Cash: $418 (2929% of Medicare)
Ins. Median: $125 (876% 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 876% of the Medicare baseline (a markup of 776%). 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 $8 - $271 56%
Aetna $14 - $224 98%
Blue Cross Blue Shield $14 - $314 98%
Bright Health $14 - $127 98%
Devoted Health $14 98%
Humana $14 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 - $191 98%
Delaware Life Insurance $15 105%
Kaiser $15 - $137 105%
Wellcare $15 105%
Pinnacol Workers Comp $39 273%
Multiplan $41 - $382 287%
Vail Health $59 - $64 413%
Colorado Program For Children With Special Needs $170 - $187 1191%
Western Plains Community Health $251 - $276 1759%
Northcare $270 - $297 1892%
Physician Health Partners $270 - $297 1892%
Medical Development International $309 - $339 2165%
Prime Health $347 - $382 2432%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 E Hampden Ave, Englewood, CO 80113
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals