CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercy Medical Center-New Hampton

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $184
  • Cash Discount Price: $127
  • vs. Medicare Baseline: 12.89x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Medical Center-New Hampton is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 12.89x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$127

Average discount available for prompt cash payment at this facility.

Insurance Median
$184

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: $127 (890%)
Insurance Median: $184 (1289%)
Cash: $127 (890% of Medicare)
Ins. Median: $184 (1289% 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 1289% of the Medicare baseline (a markup of 1189%). 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 - $184 98%
Blue Cross Blue Shield $14 98%
Medicare (plans) $14 - $80 98%
UnitedHealthcare $15 - $117 105%
Amish Hospital Aid $19 133%
Ambetter / Centene $24 168%
Claimdoc $29 203%
Nova $29 203%
Health Choices $98 687%
Medical Associates $98 687%
Oscar $115 806%
Geha $117 820%
Iowa Total Care $133 932%
Medicaid / KanCare $135 - $136 946%
1199 National Benefit Fund $184 1289%
Allied Benefit Systems $184 1289%
Asr Health Benefits $184 1289%
Coventry $184 1289%
First Health $184 1289%
Lucent Health $184 1289%
Luminare Health $184 1289%
Medical Mutual $184 1289%
Meritain $184 1289%
Trustmark Small Business Benefits $184 1289%
Webtpa $184 1289%
First Choice Health $185 1296%
Health Partners $187 1310%
Auxiant $189 1324%
Cigna $189 1324%
Medica $189 1324%
Midlands $189 1324%
Midlands Choice $189 1324%
Crime Victim Assistance $195 1367%
Iowa Dept Of Public Health $195 1367%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 308 North Maple Avenue, New Hampton, IA 50659
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals