CMS Price Transparency Data

Hepatitis C antibody test

Facility: Southern Hills Hospital and Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $15
Cash Discount Price: $968
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Southern Hills Hospital and Medical Center is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $968. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 1.05x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$968

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $968 (6783%)

Insurance Median: $15 (105%)

Cash: $968 (6783% of Medicare)

Ins. Median: $15 (105% 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.

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	$2 - $24	14%
Ambetter / Centene	$10 - $15	70%
Caresource	$10	70%
Community Care Health	$10	70%
Molina Healthcare	$10	70%
Sierra Hpn	$10	70%
Alignment Health Plan	$14	98%
Blue Cross Blue Shield	$14 - $18	98%
Health Net	$14	98%
Hometown Health Mcr	$14	98%
Humana	$14	98%
Select Health	$14 - $223	98%
Sierra	$14	98%
Triwest	$14	98%
United	$14 - $211	98%
Caremore	$15	105%
Health Services Coalition	$15	105%
Imperial Nv	$16	112%
Universal Healthcare	$17	119%
Cigna	$37	259%
Corvel	$48	336%
Olympus Medsave Usa	$50 - $726	350%
Prominence Healthfirst	$290	2032%
Cmn Global	$407	2852%
Evernorth	$484	3392%
Hometown Health Providers	$484	3392%
Nv Health & Welfare Trust	$581	4071%
Multiplan	$610 - $707	4275%
First Health	$639 - $774	4478%
Medcare International	$726	5088%

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 $968.
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 Southern Hills Hospital and Medical Center 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.