CMS Price Transparency Data

Hepatitis C antibody test

Facility: East Morgan County Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $107
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 7.50x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at East Morgan County Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 7.50x the Medicare baseline. Located in 2400 W Edison St, Brush, CO.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $129 (904%)
Insurance Median: $107 (750%)
Cash: $129 (904% of Medicare)
Ins. Median: $107 (750% 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 750% of the Medicare baseline (a markup of 650%). 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
Pinnacol Assurance Workers Comp $40 - $107 280%
Aetna $41 - $237 287%
Banner Health $41 - $110 287%
Blue Cross Blue Shield $41 - $192 287%
Clear Spring Health $41 - $110 287%
Healthspring Life & Health Insurance Company, Inc. $41 - $110 287%
Medica $41 - $212 287%
Medicare (plans) $41 - $110 287%
Triwest Healthcare Alliance Corp - Va Ccn $41 - $110 287%
UnitedHealthcare $41 - $237 287%
Longevity $42 - $113 294%
Humana $43 - $116 301%
Devoted Health Services $45 - $121 315%
Assist Health Group $49 - $132 343%
Denver Health Medical Plan $76 - $204 533%
Apostrophe, Inc. $86 - $230 603%
First Choice Health Network $86 - $230 603%
Hue Health, Inc $90 - $242 631%
Rocky Mountain Health Plans $90 - $242 631%
Multiplan $92 - $247 645%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 W Edison St, Brush, CO 80723
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals