CMS Price Transparency Data

Hepatitis C antibody test

Facility: Decatur County Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $93
  • Cash Discount Price: $90
  • vs. Medicare Baseline: 6.52x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Decatur County Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 6.52x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$90

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $90 (631%)
Insurance Median: $93 (652%)
Cash: $90 (631% of Medicare)
Ins. Median: $93 (652% 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 652% of the Medicare baseline (a markup of 552%). 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
UnitedHealthcare $16 - $98 112%
Blue Cross Blue Shield $36 - $37 252%
Wellmark Hmo $47 329%
Champva -All Plans $50 - $52 350%
Wellmark Ppo - All Other Plans $52 364%
Everystep Hospice-All Plans $58 - $60 406%
Aetna $60 - $91 420%
Tricare $60 - $62 420%
Benefit Admin System-All Plans $72 - $75 505%
Humana $81 - $84 568%
Meritain Health-All Plans $81 - $84 568%
Misc Commercial-All Plans $81 - $84 568%
All Savers-All Plans $83 - $86 582%
Allied Benefit System-All Plans $83 - $86 582%
American Family Ins Grp-All Plans $83 - $86 582%
Rural Carrier Benefit Plan-All Plans $85 - $89 596%
Christian Healthcare -All Plans $89 - $92 624%
Medica-All Other Plans $89 - $92 624%
Golden Rule-All Plans $94 - $98 659%
Ntca The Rural Broadband-All Plans $94 - $98 659%
Cigna $95 - $99 666%
Medical Mutual-All Plans $98 - $101 687%
Farm Bureau Financial-All Other Plans $100 - $104 701%
Farm Bureau Property And Ca $100 - $104 701%
Medi Share-All Plans $101 - $105 708%
Uhss-All Plans $101 - $105 708%
Health Partners-All Plans $102 - $106 715%
Lewermark-All Plans $105 - $109 736%
Mail Handlers Benefit-All Plans $109 - $113 764%
Midlands Choice-All Plans $109 - $113 764%
Priority Health-All Plans $111 - $115 778%
Iowa Total Care Mcaid-All Plans $113 - $117 792%
Amerigroup Mcaid-All Plans $117 - $121 820%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals