CMS Price Transparency Data

Hepatitis C antibody test

Facility: Children's Hospital Colorado

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $123
  • Cash Discount Price: $126
  • vs. Medicare Baseline: 8.62x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Children's Hospital Colorado is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 8.62x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$126

Average discount available for prompt cash payment at this facility.

Insurance Median
$123

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: $126 (883%)
Insurance Median: $123 (862%)
Cash: $126 (883% of Medicare)
Ins. Median: $123 (862% 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 862% of the Medicare baseline (a markup of 762%). 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
Ccha Behavioral Health $5 - $37 35%
Integrated Health Plan $8 - $56 56%
Kaiser $18 - $272 126%
Rocky Mountain Health Plan Behavioral Health $21 - $149 147%
Carelon Behavioral Health $23 - $261 161%
Denver Health Medical Plan $23 - $280 161%
UnitedHealthcare $24 - $186 168%
Colorado Access $25 - $183 175%
Colorado Access Behavioral Health $25 - $183 175%
Presbyterian Health Plan $25 - $213 175%
Blue Cross Blue Shield $27 - $280 189%
Molina Healthcare Of Nebraska $29 - $205 203%
Molina Healthcare Of New Mexico $29 - $205 203%
Peak Health Alliance/Ebms $29 - $224 203%
Rocky Mountain Health Plan $29 - $242 203%
Healthy Blue Of Nebraska $30 - $216 210%
Humana $32 - $261 224%
Evernorth Behavioral Health $34 - $242 238%
Interlink National $34 - $280 238%
Centivo $36 - $257 252%
Select Health $36 - $261 252%
Uchealth Plan Administrators $36 - $261 252%
Aetna $38 - $298 266%
Cigna $38 - $269 266%
Department Of Corrections $41 - $291 287%
Comppsych Behavioral Health $44 - $317 308%
First Choice Health $44 - $317 308%
Midlands Choice $44 - $317 308%
National Preferred Provider Network $44 - $317 308%
Multiplan $45 - $321 315%
Cofinity $47 - $336 329%
First Choice Of The Midwest $47 - $336 329%
Usa Managed Care Organization $47 - $336 329%
First Health Network $48 - $343 336%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens