CMS Price Transparency Data

Hepatitis C antibody test

Facility: Alta Vista Regional Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $149
  • Cash Discount Price: $261
  • vs. Medicare Baseline: 10.44x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Alta Vista Regional Hospital is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 10.44x the Medicare baseline. Located in 104 Legion Drive, Las Vegas, NM.
Cash / Self-Pay
$261

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $261 (1829%)
Insurance Median: $149 (1044%)
Cash: $261 (1829% of Medicare)
Ins. Median: $149 (1044% 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 1044% of the Medicare baseline (a markup of 944%). 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
Medicare (plans) $14 - $522 98%
UnitedHealthcare $14 - $83 98%
Workers Comp $14 - $522 98%
Commercial Hmo Ppo $16 - $522 112%
Medicaid / KanCare $16 - $522 112%
Champus $17 - $522 119%
Php Centennial $19 133%
Mcare Mcaid Hmo Dual $83 582%
Self Pay $261 1829%
Other Covernment $326 - $522 2285%
Blue Cross Blue Shield $391 - $522 2740%
Mva $522 3658%
Other Government $522 3658%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 104 Legion Drive, Las Vegas, NM 87701
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals