CMS Price Transparency Data

Hepatitis C antibody test

Facility: Intermountain Health Heber Valley Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $78
  • Cash Discount Price: $67
  • vs. Medicare Baseline: 5.47x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Intermountain Health Heber Valley Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.47x the Medicare baseline. Located in 454 East Medical Way, Heber City, UT.
Cash / Self-Pay
$67

Average discount available for prompt cash payment at this facility.

Insurance Median
$78

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: $67 (470%)
Insurance Median: $78 (547%)
Cash: $67 (470% of Medicare)
Ins. Median: $78 (547% 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 547% of the Medicare baseline (a markup of 447%). 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
Aetna $14 - $79 98%
American Health $14 - $27 98%
Blue Cross Blue Shield $14 - $79 98%
Health Partners Of Nevada $14 - $27 98%
Health Plan Of Nevada $14 - $79 98%
Healthy U $14 - $79 98%
Humana $14 - $27 98%
Molina $14 - $79 98%
Selecthealth $14 - $79 98%
UnitedHealthcare $14 - $79 98%
Triwest $30 - $67 210%
Corporation Of The President $67 470%
Corvel Corporation $67 470%
Injury Care Of Nevada $67 470%
Wcf Insurance $67 470%
Byu Risk Management $76 533%
Cigna $76 - $79 533%
Medcare International $76 533%
Springtide $76 533%
Uofu $76 533%
Byu Athletics $78 547%
Campbell Scientific $78 547%
Emi Health $78 547%
Franklin County $78 547%
Ifit $78 547%
Juniper Systems $78 547%
Lw Miller $78 547%
Managed Care Admin $78 547%
Motivhealth $78 547%
Prodegi Corp Benefit $78 547%
Tanner Llc $78 547%
Utah Tech $78 547%
Wise Network $78 547%
Awh Connected $79 - $80 554%
Deseret Mutual $79 554%
Emi $79 554%
Intermountain Caregiver Plan $79 554%
Pehp $79 - $80 554%
Global Excel $80 561%
Health Utah $80 561%
Hygeia Corporation $80 561%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 East Medical Way, Heber City, UT 84032
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals