CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Healthone Mountain Ridge

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $171
  • Cash Discount Price: $866
  • vs. Medicare Baseline: 11.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Healthone Mountain Ridge is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $866. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 11.98x the Medicare baseline. Located in 9191 Grant St, Thornton, CO.
Cash / Self-Pay
$866

Average discount available for prompt cash payment at this facility.

Insurance Median
$171

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: $866 (6069%)
Insurance Median: $171 (1198%)
Cash: $866 (6069% of Medicare)
Ins. Median: $171 (1198% 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 1198% of the Medicare baseline (a markup of 1098%). 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 $7 - $559 49%
Aetna $14 - $461 98%
Blue Cross Blue Shield $14 - $647 98%
Bright Health $14 - $262 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 - $393 98%
Delaware Life Insurance $15 105%
Innovage Pace $15 105%
Kaiser $15 - $310 105%
Wellcare $15 105%
Pinnacol Workers Comp $39 273%
Multiplan $41 - $787 287%
Vail Health $130 - $133 911%
Colorado Program For Children With Special Needs $292 - $297 2046%
Life Source Services $350 2453%
Western Plains Community Health $558 - $568 3910%
Northcare $601 - $612 4212%
Physician Health Partners $601 - $612 4212%
Medical Development International $686 - $699 4807%
Prime Health $772 - $787 5410%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9191 Grant St, Thornton, CO 80229
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals