CMS Price Transparency Data
Hepatitis C antibody test
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $44
- Cash Discount Price: $49
- vs. Medicare Baseline: 3.08x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at St Joe Mercy Hospital System Livonia is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.08x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$49
Average discount available for prompt cash payment at this facility.
Insurance Median
$44
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: $49 (343%)
Insurance Median: $44 (308%)
Cash: $49 (343% of Medicare)
Ins. Median: $44 (308% 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 308% of the Medicare baseline (a markup of 208%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $8 - $14 | 56% |
| Medicaid / KanCare | $8 | 56% |
| Bcn Domestic | $13 | 91% |
| Blue Benefit Administrators Of Massachusetts | $13 | 91% |
| Blue Care Network | $13 | 91% |
| Blue Distinction Transplant | $13 | 91% |
| Blue Shield - Ca | $13 | 91% |
| Blue Shield - Id (Regence) | $13 | 91% |
| Blue Shield - Ny Highmark Northeastern | $13 | 91% |
| Blue Shield - Ny Highmark Western | $13 | 91% |
| Blue Shield - Pa (Highmark) | $13 | 91% |
| Blue Shield - Wa (Regence) | $13 | 91% |
| Health Choices | $13 - $53 | 91% |
| Kaiser Domestic | $13 | 91% |
| Aetna | $14 - $36 | 98% |
| Align Senior Care | $14 | 98% |
| Angela Hospice | $14 | 98% |
| Blue Care Network Advantage | $14 | 98% |
| Hospice Of Michigan | $14 | 98% |
| Medicare (plans) | $14 - $15 | 98% |
| Cca - Zing Health | $15 | 105% |
| UnitedHealthcare | $15 - $53 | 105% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $16 | 112% |
| U Of M Health Plan | $17 | 119% |
| Molina Marketplace | $19 | 133% |
| Wc Accident Fund | $19 - $23 | 133% |
| Wc Advantage | $19 - $23 | 133% |
| Wc Aig | $19 - $23 | 133% |
| Wc Allied | $19 - $23 | 133% |
| Wc Amerisure | $19 - $23 | 133% |
| Wc Amtrust | $19 - $23 | 133% |
| Wc Asu Risk Mgt | $19 - $23 | 133% |
| Wc Berkley Admin | $19 - $23 | 133% |
| Wc Broadspire | $19 - $23 | 133% |
| Wc Bunch & Associates | $19 - $23 | 133% |
| Wc Ccmsi | $19 - $23 | 133% |
| Wc Emc Insurance Company | $19 - $23 | 133% |
| Wc Esis | $19 - $23 | 133% |
| Wc Fcci | $19 - $23 | 133% |
| Wc Federated | $19 - $23 | 133% |
| Wc Gallagher Bassett | $19 - $23 | 133% |
| Wc Genex Care For Ohio | $19 - $23 | 133% |
| Wc Guard Insurance Company | $19 - $23 | 133% |
| Wc Hartford | $19 - $23 | 133% |
| Wc Liberty Mutual | $19 - $23 | 133% |
| Wc Meijers | $19 - $23 | 133% |
| Wc Michigan | $19 - $23 | 133% |
| Wc Mitchell Frankenmuth | $19 - $23 | 133% |
| Wc Pma | $19 - $23 | 133% |
| Wc Sedgwick | $19 - $23 | 133% |
| Wc Sentry | $19 - $23 | 133% |
| Wc Travelers | $19 - $23 | 133% |
| Wc Tristar | $19 - $23 | 133% |
| Wc Walmart | $19 - $23 | 133% |
| Wc Zurich | $19 - $23 | 133% |
| Geha | $21 - $53 | 147% |
| Luminare Health (Detroit) | $21 | 147% |
| Meritain | $21 | 147% |
| Health Cost Solutions | $22 | 154% |
| Vitalcore | $22 | 154% |
| Wellpath | $22 | 154% |
| Acs Benefit Services | $29 - $35 | 203% |
| Allied Benefit Systems | $29 - $35 | 203% |
| Claimchoice Adminstrators | $29 - $35 | 203% |
| Consociate | $29 - $35 | 203% |
| Cypress Benefit Administrators | $29 - $35 | 203% |
| Forest County Potawatomi | $29 - $35 | 203% |
| Health Smart | $29 - $35 | 203% |
| Healthgram | $29 - $35 | 203% |
| Healthscope | $29 - $35 | 203% |
| Secureone Preferred United Plans | $29 - $35 | 203% |
| Sisco Benefits | $29 - $35 | 203% |
| The Health Plan | $29 - $35 | 203% |
| Trustmark Small Business Benefits | $29 - $35 | 203% |
| Unified Group Services | $29 - $35 | 203% |
| Webtpa | $29 - $35 | 203% |
| Priority Health | $31 - $35 | 217% |
| Employee Benefit Logistic | $32 | 224% |
| Hap | $42 - $51 | 294% |
| Health Partners | $42 - $51 | 294% |
| Tufts Health Plan | $42 - $51 | 294% |
| Cigna | $43 - $66 | 301% |
| 1199 National Benefit Fund | $44 - $53 | 308% |
| Access Health | $44 - $53 | 308% |
| Acclaim | $44 - $53 | 308% |
| Administrative Concepts | $44 - $53 | 308% |
| Allegeant | $44 - $53 | 308% |
| Allied National Global Care | $44 - $53 | 308% |
| Ameriben | $44 - $53 | 308% |
| American Family | $44 - $53 | 308% |
| American Healthcare Alliance | $44 - $53 | 308% |
| American National | $44 - $53 | 308% |
| American Republic | $44 - $53 | 308% |
| Amerihealth | $44 - $53 | 308% |
| Asrm - Reliance Standard Life Insurance | $44 - $53 | 308% |
| Aultcare | $44 - $53 | 308% |
| Automated Benefit Services | $44 - $53 | 308% |
| Auxiant | $44 - $53 | 308% |
| Benefit Administrative Systems,Llc | $44 - $53 | 308% |
| Boon Chapman | $44 - $53 | 308% |
| Cam Administrative Services | $44 - $53 | 308% |
| Christian Brother Services | $44 - $53 | 308% |
| Christian Brothers Holy Cross | $44 - $53 | 308% |
| Christian Care Ministry | $44 - $53 | 308% |
| Comprehensive Benefits | $44 - $53 | 308% |
| Continental Life Insurance | $44 - $53 | 308% |
| Custom Benefit Administrators | $44 - $53 | 308% |
| Dean Health | $44 - $53 | 308% |
| Employee Benefit Concepts | $44 - $53 | 308% |
| Employee Benefit Management | $44 - $53 | 308% |
| Enterprise Group Planning | $44 - $53 | 308% |
| Fallon Health | $44 - $53 | 308% |
| Family Life Insurance Company | $44 - $53 | 308% |
| Freedom Life Insurance Company | $44 - $53 | 308% |
| Ghc Scw | $44 - $53 | 308% |
| Group Administrators | $44 - $53 | 308% |
| Group Marketing Services | $44 - $53 | 308% |
| Group Pension Administrators | $44 - $53 | 308% |
| Guardian | $44 - $53 | 308% |
| Health America | $44 - $53 | 308% |
| Healthcare Management Admin | $44 - $53 | 308% |
| Healthez | $44 - $53 | 308% |
| Humana | $44 - $53 | 308% |
| Insight | $44 - $53 | 308% |
| Intercare | $44 - $53 | 308% |
| International Benefit Administrators | $44 - $53 | 308% |
| Jfp Benefit Management | $44 - $53 | 308% |
| Jp Farley Corporation | $44 - $53 | 308% |
| Key Benefit Administrator | $44 - $53 | 308% |
| Liberty Union Life Assurance Co | $44 - $53 | 308% |
| Lifetime Benefit Solutions | $44 - $53 | 308% |
| Lucent Health | $44 - $53 | 308% |
| Luminare Health | $44 - $53 | 308% |
| Magnacare | $44 - $53 | 308% |
| Manhattan Life | $44 - $53 | 308% |
| Medben | $44 - $53 | 308% |
| Medcost | $44 - $53 | 308% |
| Medi Share | $44 - $53 | 308% |
| Medical Mutual | $44 - $53 | 308% |
| Multiplan | $44 - $53 | 308% |
| Mutual Health Services | $44 - $53 | 308% |
| Mutual Of Omaha | $44 - $53 | 308% |
| Mvp | $44 - $53 | 308% |
| Ncas | $44 - $53 | 308% |
| Nippon Life Ins | $44 - $53 | 308% |
| Nova | $44 - $53 | 308% |
| Pai | $44 - $53 | 308% |
| Painters Union Insurance Fund | $44 - $53 | 308% |
| Pan-American Life | $44 - $53 | 308% |
| Paramount Hmo | $44 - $53 | 308% |
| Phcs | $44 - $53 | 308% |
| Physicians Mutual | $44 - $53 | 308% |
| Plumbers Local 98 Insurance Fund | $44 - $53 | 308% |
| Prairie States | $44 - $53 | 308% |
| Preferred One | $44 - $53 | 308% |
| Primary Physician Care | $44 - $53 | 308% |
| Professional Benefit Administrators | $44 - $53 | 308% |
| Siho Insurance Services | $44 - $53 | 308% |
| The Loomis Company | $44 - $53 | 308% |
| Trinity Health Share | $44 - $53 | 308% |
| Unicare | $44 - $53 | 308% |
| Us Health And Life | $44 - $53 | 308% |
| Valenz | $44 - $53 | 308% |
| Western & Southern Financial Group | $44 - $53 | 308% |
| Wps | $44 - $53 | 308% |
| First Health | $45 - $54 | 315% |
| Asr Health Benefits | $51 | 357% |
| Caresource | $51 | 357% |
| Varipro | $51 | 357% |
| Coventry | $55 - $66 | 385% |
| Prime Health Services | $55 - $66 | 385% |
| Three Rivers Provider Network | $62 - $75 | 434% |
| Carelon Behavioral Health | $69 - $83 | 484% |
| Cmh Detroit Wayne Integrated Health Network | $69 - $83 | 484% |
| Cmh Lenawee County | $69 - $83 | 484% |
| Cmh Livingston County | $69 - $83 | 484% |
| Cmh Misc | $69 - $83 | 484% |
| Cmh Monroe County | $69 - $83 | 484% |
| Cmh Washtenaw County | $69 - $83 | 484% |
| Magellan Behavioral Health | $69 - $83 | 484% |