CMS Price Transparency Data

Hepatitis C antibody test

Facility: Intermountain Health St Vincent Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $53
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.71x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Intermountain Health St Vincent Regional Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.71x the Medicare baseline. Located in 1233 N 30Th St, Billings, MT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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%)

Insurance Median: $53 (371%)

Ins. Median: $53 (371% 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 371% of the Medicare baseline (a markup of 271%). 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
Medicare (plans)	$14	98%
UnitedHealthcare	$15 - $69	105%
Ebms-Employee Benefit Mng	$24 - $64	168%
Sibanye Stillwater Health Partners	$27	189%
Coastal Administrative Services	$29	203%
Exchange Other	$33 - $49	231%
Mt Health Co-Op	$33 - $49	231%
First Choice Health	$34 - $67	238%
Other	$34 - $67	238%
Allegiance	$36 - $67	252%
Pacific Steel And Recycling	$36	252%
Pacificsource	$36 - $68	252%
Blue Cross Blue Shield	$38 - $114	266%
Meritain Health	$40 - $56	280%
Aetna	$41 - $48	287%
Cigna	$42 - $67	294%
Preferred One	$55 - $70	385%
Interwest	$58 - $67	406%
Geha	$59 - $69	413%
Private Hlthcare Sys	$59 - $68	413%

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 $X.
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 Intermountain Health St Vincent Regional 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.