CMS Price Transparency Data

Hepatitis C antibody test

Facility: HCA Healthone Spalding Rehabilitation

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $46
Cash Discount Price: $221
vs. Medicare Baseline: 3.22x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at HCA Healthone Spalding Rehabilitation is $46. 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 3.22x the Medicare baseline. Located in 900 Potomac St, Aurora, CO.

Cash / Self-Pay

$221

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $46 (322%)

Cash: $221 (1549% of Medicare)

Ins. Median: $46 (322% 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 322% of the Medicare baseline (a markup of 222%). 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	$14 - $112	98%
Blue Cross Blue Shield	$14 - $150	98%
Bright Health	$14	98%
Cigna	$14 - $141	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 - $99	98%
Delaware Life Insurance	$15	105%
Innovage Pace	$15	105%
Kaiser	$15 - $132	105%
Wellcare	$15	105%
Vail Health	$34	238%
Pinnacol Workers Comp	$39	273%
Multiplan	$41 - $199	287%
Western Plains Community Health	$143	1002%
Prime Health	$199	1395%

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 $221.
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 HCA Healthone Spalding Rehabilitation 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.