CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercyone Dyersville Medical Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $161
  • Cash Discount Price: $127
  • vs. Medicare Baseline: 11.28x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercyone Dyersville Medical Center is $161. 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 11.28x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.
Cash / Self-Pay
$127

Average discount available for prompt cash payment at this facility.

Insurance Median
$161

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: $161 (1128%)
Cash: $127 (890% of Medicare)
Ins. Median: $161 (1128% 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 1128% of the Medicare baseline (a markup of 1028%). 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
Blue Cross Blue Shield $14 98%
Medicare (plans) $14 - $111 98%
UnitedHealthcare $15 - $136 105%
Amish Hospital Aid $19 133%
Ambetter / Centene $24 168%
Claimdoc $29 203%
Nova $29 203%
Health Choices $74 519%
The Alliance $119 834%
Iowa Total Care $135 946%
Geha $136 953%
Medicaid / KanCare $137 - $138 960%
1199 National Benefit Fund $161 1128%
Aetna $161 1128%
Allied Benefit Systems $161 1128%
Asr Health Benefits $161 1128%
Christian Brother Services $161 1128%
Coventry $161 1128%
First Health $161 1128%
Luminare Health $161 1128%
Medical Mutual $161 1128%
Meritain $161 1128%
Trustmark Small Business Benefits $161 1128%
Webtpa $161 1128%
Auxiant $176 1233%
Cigna $176 1233%
Medica $176 1233%
Midlands $176 1233%
Midlands Choice $176 1233%
Multiplan $176 1233%
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: 1111 3Rd Street Sw, Dyersville, IA 52040
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals