CMS Price Transparency Data

Hepatitis C antibody test

Facility: Aspen Valley Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $124
Cash Discount Price: $124
vs. Medicare Baseline: 8.69x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Aspen Valley Hospital is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.69x the Medicare baseline. Located in 401 Castle Creek Rd, Aspen, CO.

Cash / Self-Pay

$124

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $124 (869%)

Insurance Median: $124 (869%)

Cash: $124 (869% of Medicare)

Ins. Median: $124 (869% 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 869% of the Medicare baseline (a markup of 769%). 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
Aetna	$51 - $139	357%
Blue Cross Blue Shield	$51 - $129	357%
Humana	$51 - $132	357%
Medicare (plans)	$51 - $75	357%
Tricare	$51 - $139	357%
UnitedHealthcare	$51 - $139	357%
Veterans Administration [100068]	$51 - $75	357%
Cigna	$66 - $139	463%
Allied Benefit Systems [100015]	$90 - $132	631%
Geha [100039]	$90 - $132	631%
Healthscope [100157]	$90 - $132	631%
Aarp [100007]	$95 - $139	666%
Aig Travel [100255]	$95 - $139	666%
Aig [700029]	$95 - $139	666%
Ameriben [100266]	$95 - $139	666%
American Republic [100018]	$95 - $139	666%
Amtrust North America [700042]	$95 - $139	666%
Axa Travel [100256]	$95 - $139	666%
Bankers Life Casualty [100022]	$95 - $139	666%
Broadspire [700043]	$95 - $139	666%
Bupa Global [100257]	$95 - $139	666%
Ccmsi [700017]	$95 - $139	666%
Champ Va [500001]	$95 - $139	666%
Chp [300053]	$95 - $139	666%
Chubb Services [700054]	$95 - $139	666%
Companion Life Pivot Health [100258]	$95 - $139	666%
Corvel [700058]	$95 - $139	666%
Employee Benefit Management [100033]	$95 - $139	666%
Equitable Life [100160]	$95 - $139	666%
Esis Work Comp [700010]	$95 - $139	666%
Freedom Life Insurance Company [100158]	$95 - $139	666%
Gallagher Bassett Work Comp [700013]	$95 - $139	666%
Generic Commercial [109999]	$95 - $139	666%
Generic Other [509999]	$95 - $139	666%
Generic Travel Insurance [109998]	$95 - $139	666%
Generic Workers' Comp [709999]	$95 - $139	666%
Gerber Life Insurance [100265]	$95 - $139	666%
Global Excel [100259]	$95 - $139	666%
Gmmi [100260]	$95 - $139	666%
Hartford Work Comp [700055]	$95 - $139	666%
Harvard Pilgrim Healthcare [100241]	$95 - $139	666%
Health Net [100261]	$95 - $139	666%
Imagine 360 [100043]	$95 - $139	666%
Kaiser Permanente [100254]	$95 - $139	666%
Liberty Healthshare [100262]	$95 - $139	666%
Liberty Mutual Work Comp [700016]	$95 - $139	666%
Marriott Claim [700056]	$95 - $139	666%
Medi Share [100263]	$95 - $139	666%
Medicaid / KanCare	$95 - $139	666%
Mutual Of Omaha [100074]	$95 - $139	666%
Owcp [700057]	$95 - $139	666%
Physicians Mutual [100075]	$95 - $139	666%
Pinnacol Assurance Wc [700059]	$95 - $139	666%
Relations Insurance Kaiser [800004]	$95 - $139	666%
Sedgwick [700027]	$95 - $139	666%
Sentinel Security Life [100264]	$95 - $139	666%
Skico Ortho Alternative Payer [100163]	$95 - $139	666%
Transamerica [100097]	$95 - $139	666%
Travelers Work Comp [700028]	$95 - $139	666%
Tufts Health Plan [100268]	$95 - $139	666%
United American Insurance [100119]	$95 - $139	666%
Usaa Life Insurance Company [100155]	$95 - $139	666%
Wea [100120]	$95 - $139	666%

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 $124.
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 Aspen Valley 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.