CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercyone Oelwein Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $179
  • Cash Discount Price: $127
  • vs. Medicare Baseline: 12.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercyone Oelwein Medical Center is $179. 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 12.54x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$127

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $179 (1254%)
Cash: $127 (890% of Medicare)
Ins. Median: $179 (1254% 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 1254% of the Medicare baseline (a markup of 1154%). 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 - $179 98%
Blue Cross Blue Shield $14 98%
Medicare (plans) $14 - $82 98%
UnitedHealthcare $15 - $138 105%
Amish Hospital Aid $19 133%
Centivo $21 147%
Ambetter / Centene $24 168%
Claimdoc $29 203%
Nova $29 203%
Iowa Total Care $76 533%
Medicaid / KanCare $77 540%
Geha $138 967%
Health Choices $144 1009%
Medical Associates $144 1009%
1199 National Benefit Fund $179 1254%
Allied Benefit Systems $179 1254%
Asr Health Benefits $179 1254%
Christian Brother Services $179 1254%
Coventry $179 1254%
First Health $179 1254%
Lucent Health $179 1254%
Luminare Health $179 1254%
Medical Mutual $179 1254%
Meritain $179 1254%
Trustmark Small Business Benefits $179 1254%
Webtpa $179 1254%
Health Partners $188 1317%
Multiplan $189 1324%
Auxiant $191 1338%
Cigna $191 1338%
Medica $191 1338%
Midlands $191 1338%
Midlands Choice $191 1338%
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: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals