CMS Price Transparency Data

Hepatitis C antibody test

Facility: Summerlin Hospital Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $89
  • Cash Discount Price: $252
  • vs. Medicare Baseline: 6.24x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Summerlin Hospital Medical Center is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $252. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.24x the Medicare baseline. Located in 657 Town Center Drive, Las Vegas, NV.
Cash / Self-Pay
$252

Average discount available for prompt cash payment at this facility.

Insurance Median
$89

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: $252 (1766%)
Insurance Median: $89 (624%)
Cash: $252 (1766% of Medicare)
Ins. Median: $89 (624% 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 624% of the Medicare baseline (a markup of 524%). 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
Blue Cross Blue Shield $7 - $10 49%
Molina $10 70%
Silver_Summit $10 70%
Smart_Choice $10 70%
Cigna $12 - $17 84%
Humana $14 98%
United_Healthcare $21 147%
Prominence $83 - $111 582%
Sierra_Health_Options $112 - $131 785%
Aetna $183 - $469 1282%
Sierra_Health_Plan_Of_Nevada $186 - $218 1303%
Multiplan $337 - $394 2362%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 657 Town Center Drive, Las Vegas, NV 89144
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals