CMS Price Transparency Data

Hepatitis C antibody test

Facility: Intermountain Health Garfield Memorial Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $85
Cash Discount Price: $67
vs. Medicare Baseline: 5.96x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Intermountain Health Garfield Memorial Hospital is $85. 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 5.96x the Medicare baseline. Located in 200 North 400 East, Panguitch, UT.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $85 (596%)

Cash: $67 (470% of Medicare)

Ins. Median: $85 (596% 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 596% of the Medicare baseline (a markup of 496%). 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
Health Choice Utah	$14 - $79	98%
Healthy U	$14 - $79	98%
Medicare (plans)	$14 - $34	98%
Molina	$14 - $85	98%
Molina Healthcare Of Utah	$14 - $85	98%
Selecthealth	$14 - $85	98%
Uofu	$14 - $85	98%
Aetna	$16 - $86	112%
Tricare	$39 - $46	273%
Triwest	$39 - $46	273%
UnitedHealthcare	$73 - $75	512%
Blue Cross Blue Shield	$85	596%
Byu Athletic Department	$85	596%
Campbell Scientific	$85	596%
Cigna	$85	596%
Deseret Mutual	$85	596%
Emi Health	$85	596%
Franklin County	$85	596%
Health Utah	$85	596%
Hygeia Corporation	$85	596%
Juniper Systems	$85	596%
Lw Miller	$85	596%
Managed Care Administrators, Inc.	$85	596%
Medcare International	$85	596%
Motivhealth	$85	596%
Pehp	$85	596%
Prodegi Corporate Benefit Services, Llc	$85	596%
Springtide	$85	596%
Tanner Llc	$85	596%
Utah State University	$85	596%
Utah Tech University	$85	596%
Wise	$85	596%

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 $67.
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 Garfield Memorial 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.