CMS Price Transparency Data

Hepatitis C antibody test

Facility: Craig Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $400
  • Cash Discount Price: $221
  • vs. Medicare Baseline: 28.03x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Craig Hospital is $400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $221. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 28.03x the Medicare baseline. Located in 3425 S Clarkson St, Englewood, CO.
Cash / Self-Pay
$221

Average discount available for prompt cash payment at this facility.

Insurance Median
$400

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: $221 (1549%)
Insurance Median: $400 (2803%)
Cash: $221 (1549% of Medicare)
Ins. Median: $400 (2803% 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 2803% of the Medicare baseline (a markup of 2703%). 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
Veterans Administration $12 84%
Cms $14 98%
UnitedHealthcare $14 - $289 98%
Cigna $294 2060%
Kaiser $302 2116%
Blue Cross Blue Shield $308 2158%
Carisk Outcomes $320 2242%
Zenith $346 2425%
Aetna $362 2537%
Corvel Worker'S Comp $373 2614%
Liberty Mutual Worker'S Comp $373 2614%
Paradigm $373 - $394 2614%
Rocky Mountain Health Plan $389 - $416 2726%
Midwest Employers Casualty $394 2761%
Coventry/First Health $400 2803%
Fcci Worker'S Comp $400 2803%
Geha/Ppo Usa $400 2803%
Great-West Healthcare $400 2803%
Multiplan/Phcs $400 - $421 2803%
Prime Health Services $405 2838%
First Choice Health $416 2915%
Focus Worker'S Comp $426 2985%
General Reinsurance $426 - $453 2985%
Provider Network Of America $426 2985%
Three Rivers Provider Network $426 - $437 2985%
Wyoming Worker'S Comp $426 2985%
Allstate $453 3174%
Tricare $453 3174%
National Provider Network $480 3364%
Up & Up $480 3364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3425 S Clarkson St, Englewood, CO 80113
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL