CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercyone Des Moines Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $84
  • Cash Discount Price: $158
  • vs. Medicare Baseline: 5.89x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercyone Des Moines Medical Center is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.89x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$158

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $158 (1107%)
Insurance Median: $84 (589%)
Cash: $158 (1107% of Medicare)
Ins. Median: $84 (589% 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 589% of the Medicare baseline (a markup of 489%). 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 - $84 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 - $243 98%
Amish Hospital Aid $19 133%
Oscar $20 140%
Centivo $21 147%
Ambetter / Centene $24 168%
Claimdoc $29 203%
Nova $29 203%
Health Choices $49 343%
Medical Associates $49 343%
1199 National Benefit Fund $84 589%
Allied Benefit Systems $84 589%
Asr Health Benefits $84 589%
Christian Brother Services $84 589%
Coventry $84 589%
First Health $84 589%
Lucent Health $84 589%
Luminare Health $84 589%
Medical Mutual $84 589%
Meritain $84 589%
Trustmark Small Business Benefits $84 589%
Webtpa $84 589%
Cigna $146 1023%
Health Partners $154 1079%
Auxiant $158 1107%
Medica $158 1107%
Midlands $158 1107%
Midlands Choice $158 1107%
Usa Managed Care $207 1451%
Crime Victim Assistance $243 1703%
Iowa Dept Of Public Health $243 1703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals