CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercyone Dubuque Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $307
  • Cash Discount Price: $241
  • vs. Medicare Baseline: 21.51x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercyone Dubuque Medical Center is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 21.51x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$241

Average discount available for prompt cash payment at this facility.

Insurance Median
$307

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: $241 (1689%)
Insurance Median: $307 (2151%)
Cash: $241 (1689% of Medicare)
Ins. Median: $307 (2151% 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 2151% of the Medicare baseline (a markup of 2051%). 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 - $309 98%
Blue Cross Blue Shield $14 98%
Geha $14 98%
Iowa Total Care $14 98%
Medicaid / KanCare $14 98%
Medicare (plans) $14 - $15 98%
UnitedHealthcare $14 - $370 98%
Preferred Health Choice $15 105%
Amish Hospital Aid $19 133%
Oscar $19 133%
Centivo $22 154%
Ambetter / Centene $24 168%
Claimdoc $29 203%
Nova $29 203%
Health Choices $135 946%
Midlands Choice $215 - $333 1507%
Wps $222 1556%
The Alliance $224 1570%
Mhnet $296 2074%
1199 National Benefit Fund $309 2165%
Allied Benefit Systems $309 2165%
Asr Health Benefits $309 2165%
Christian Brother Services $309 2165%
Coventry $309 2165%
First Health $309 2165%
Lucent Health $309 2165%
Luminare Health $309 2165%
Medical Mutual $309 2165%
Meritain $309 2165%
Trustmark Small Business Benefits $309 2165%
Webtpa $309 2165%
Auxiant $333 2334%
Cigna $333 2334%
Medica $333 2334%
Midlands $333 2334%
Multiplan $333 2334%
Unity $333 2334%
Crime Victim Assistance $370 2593%
Iowa Dept Of Public Health $370 2593%
Stephenson Cty Health $370 2593%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals