CMS Price Transparency Data
Hepatitis C antibody test
Facility: Mercy Health Saint Mary's
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $55
- Cash Discount Price: $50
- vs. Medicare Baseline: 3.85x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Health Saint Mary's is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.85x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$50
Average discount available for prompt cash payment at this facility.
Insurance Median
$55
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: $50 (350%)
Insurance Median: $55 (385%)
Cash: $50 (350% of Medicare)
Ins. Median: $55 (385% 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 385% of the Medicare baseline (a markup of 285%). 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.
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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 - $19 | 56% |
| Medicaid / KanCare | $8 | 56% |
| Access Health | $10 | 70% |
| Aetna | $14 - $36 | 98% |
| Align Senior Care | $14 | 98% |
| Blue Care Network Advantage | $14 | 98% |
| Correctional Recovery | $14 | 98% |
| Hospice Faith | $14 | 98% |
| Hospice Of Holland | $14 | 98% |
| Medicare (plans) | $14 | 98% |
| Oscar | $14 | 98% |
| UnitedHealthcare | $15 - $82 | 105% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $16 | 112% |
| U Of M Health Plan | $17 - $62 | 119% |
| Bcn Domestic | $19 | 133% |
| Blue Benefit Administrators Of Massachusetts | $19 | 133% |
| Blue Care Network | $19 | 133% |
| Blue Distinction Transplant | $19 | 133% |
| Blue Shield - Ca | $19 | 133% |
| Blue Shield - Id (Regence) | $19 | 133% |
| Blue Shield - Ny Highmark Northeastern | $19 | 133% |
| Blue Shield - Ny Highmark Western | $19 | 133% |
| Blue Shield - Pa (Highmark) | $19 | 133% |
| Blue Shield - Wa (Regence) | $19 | 133% |
| Health Choices | $19 - $62 | 133% |
| Kaiser Domestic | $19 | 133% |
| Molina Marketplace | $19 | 133% |
| Geha | $21 - $62 | 147% |
| Medical Mutual | $21 | 147% |
| Meritain | $21 | 147% |
| Preferred One | $21 | 147% |
| Vitalcore | $22 | 154% |
| Wellpath | $22 | 154% |
| Wc Accident Fund | $39 - $45 | 273% |
| Wc Advantage | $39 - $45 | 273% |
| Wc Aig | $39 - $45 | 273% |
| Wc Allied | $39 - $45 | 273% |
| Wc Amerisure | $39 - $45 | 273% |
| Wc Amtrust | $39 - $45 | 273% |
| Wc Asu Risk Mgt | $39 - $45 | 273% |
| Wc Berkley Admin | $39 - $45 | 273% |
| Wc Broadspire | $39 - $45 | 273% |
| Wc Bunch & Associates | $39 - $45 | 273% |
| Wc Ccmsi | $39 - $45 | 273% |
| Wc Emc Insurance Company | $39 - $45 | 273% |
| Wc Esis | $39 - $45 | 273% |
| Wc Fcci | $39 - $45 | 273% |
| Wc Federated | $39 - $45 | 273% |
| Wc Gallagher Bassett | $39 - $45 | 273% |
| Wc Genex Care For Ohio | $39 - $45 | 273% |
| Wc Guard Insurance Company | $39 - $45 | 273% |
| Wc Hartford | $39 - $45 | 273% |
| Wc Liberty Mutual | $39 - $45 | 273% |
| Wc Meijers | $39 - $45 | 273% |
| Wc Michigan | $39 - $45 | 273% |
| Wc Mitchell Frankenmuth | $39 - $45 | 273% |
| Wc Pma | $39 - $45 | 273% |
| Wc Sedgwick | $39 - $45 | 273% |
| Wc Sentry | $39 - $45 | 273% |
| Wc Travelers | $39 - $45 | 273% |
| Wc Tristar | $39 - $45 | 273% |
| Wc Walmart | $39 - $45 | 273% |
| Wc Zurich | $39 - $45 | 273% |
| Nomi Health | $40 - $46 | 280% |
| Acs Benefit Services | $41 - $47 | 287% |
| Allied Benefit Systems | $41 - $47 | 287% |
| Claimchoice Adminstrators | $41 - $47 | 287% |
| Consociate | $41 - $47 | 287% |
| Cypress Benefit Administrators | $41 - $47 | 287% |
| Forest County Potawatomi | $41 - $47 | 287% |
| Health Smart | $41 - $47 | 287% |
| Healthgram | $41 - $47 | 287% |
| Healthscope | $41 - $47 | 287% |
| Secureone Preferred United Plans | $41 - $47 | 287% |
| Sisco Benefits | $41 - $47 | 287% |
| The Health Plan | $41 - $47 | 287% |
| Trustmark Small Business Benefits | $41 - $47 | 287% |
| Unified Group Services | $41 - $47 | 287% |
| Webtpa | $41 - $47 | 287% |
| Asr Health Benefits | $46 - $52 | 322% |
| Hap | $46 - $64 | 322% |
| Caresource | $47 - $54 | 329% |
| Varipro | $47 - $53 | 329% |
| 1199 National Benefit Fund | $53 - $60 | 371% |
| Allied National Global Care | $53 - $60 | 371% |
| Asrm - Reliance Standard Life Insurance | $53 - $60 | 371% |
| Christian Care Ministry | $53 - $60 | 371% |
| Cigna | $53 - $60 | 371% |
| Dean Health | $53 - $60 | 371% |
| Fallon Health | $53 - $60 | 371% |
| Family Life Insurance Company | $53 - $60 | 371% |
| Ghc Scw | $53 - $60 | 371% |
| Group Pension Administrators | $53 - $60 | 371% |
| International Benefit Administrators | $53 - $60 | 371% |
| Lifetime Benefit Solutions | $53 - $60 | 371% |
| Manhattan Life | $53 - $60 | 371% |
| Medi Share | $53 - $60 | 371% |
| Multiplan | $53 - $60 | 371% |
| Mvp | $53 - $60 | 371% |
| Pai | $53 - $60 | 371% |
| Pan-American Life | $53 - $60 | 371% |
| Paramount Hmo | $53 - $60 | 371% |
| Phcs | $53 - $60 | 371% |
| Trinity Health Share | $53 - $60 | 371% |
| Acclaim | $55 - $62 | 385% |
| Administrative Concepts | $55 - $62 | 385% |
| Allegeant | $55 - $62 | 385% |
| Ameriben | $55 - $62 | 385% |
| American Family | $55 - $62 | 385% |
| American Healthcare Alliance | $55 - $62 | 385% |
| American Republic | $55 - $62 | 385% |
| Amerihealth | $55 - $62 | 385% |
| Aultcare | $55 - $62 | 385% |
| Automated Benefit Services | $55 - $62 | 385% |
| Auxiant | $55 - $62 | 385% |
| Benefit Administrative Systems,Llc | $55 - $62 | 385% |
| Boon Chapman | $55 - $62 | 385% |
| Cam Administrative Services | $55 - $62 | 385% |
| Christian Brother Services | $55 - $62 | 385% |
| Christian Brothers Holy Cross | $55 - $62 | 385% |
| Comprehensive Benefits | $55 - $62 | 385% |
| Continental Life Insurance | $55 - $62 | 385% |
| Custom Benefit Administrators | $55 - $62 | 385% |
| Employee Benefit Concepts | $55 - $62 | 385% |
| Employee Benefit Management | $55 - $62 | 385% |
| Enterprise Group Planning | $55 - $62 | 385% |
| Freedom Life Insurance Company | $55 - $62 | 385% |
| Group Administrators | $55 - $62 | 385% |
| Group Marketing Services | $55 - $62 | 385% |
| Guardian | $55 - $62 | 385% |
| Health America | $55 - $62 | 385% |
| Healthez | $55 - $62 | 385% |
| Humana | $55 - $82 | 385% |
| Insight | $55 - $62 | 385% |
| Intercare | $55 - $62 | 385% |
| Jfp Benefit Management | $55 - $62 | 385% |
| Jp Farley Corporation | $55 - $62 | 385% |
| Key Benefit Administrator | $55 - $62 | 385% |
| Liberty Union Life Assurance Co | $55 - $62 | 385% |
| Lucent Health | $55 - $62 | 385% |
| Luminare Health | $55 - $62 | 385% |
| Luminare Health (Detroit) | $55 - $62 | 385% |
| Medben | $55 - $62 | 385% |
| Medcost | $55 - $62 | 385% |
| Mutual Health Services | $55 - $62 | 385% |
| Mutual Of Omaha | $55 - $62 | 385% |
| Ncas | $55 - $62 | 385% |
| Nippon Life Ins | $55 - $62 | 385% |
| Nova | $55 - $62 | 385% |
| Painters Union Insurance Fund | $55 - $62 | 385% |
| Physicians Mutual | $55 - $62 | 385% |
| Plumbers Local 98 Insurance Fund | $55 - $62 | 385% |
| Prairie States | $55 - $62 | 385% |
| Primary Physician Care | $55 - $62 | 385% |
| Professional Benefit Administrators | $55 - $62 | 385% |
| The Loomis Company | $55 - $62 | 385% |
| Unicare | $55 - $62 | 385% |
| Us Health And Life | $55 - $62 | 385% |
| Valenz | $55 - $62 | 385% |
| Western & Southern Financial Group | $55 - $62 | 385% |
| Wps | $55 - $62 | 385% |
| Coventry | $57 - $65 | 399% |
| First Health | $57 - $65 | 399% |
| Cmh Allegan County | $72 - $82 | 505% |
| Cmh Ausable Valley | $72 - $82 | 505% |
| Cmh Barry County | $72 - $82 | 505% |
| Cmh Berrien County | $72 - $82 | 505% |
| Cmh Cass County | $72 - $82 | 505% |
| Cmh Clinton-Eaton-Ingham County | $72 - $82 | 505% |
| Cmh Kalamazoo | $72 - $82 | 505% |
| Cmh Kent County | $72 - $82 | 505% |
| Cmh Lenawee County | $72 - $82 | 505% |
| Cmh Misc | $72 - $82 | 505% |
| Cmh Monroe County | $72 - $82 | 505% |
| Cmh Montcalm County | $72 - $82 | 505% |
| Cmh Muskegon County | $72 - $82 | 505% |
| Cmh Newaygo County | $72 - $82 | 505% |
| Cmh North Country | $72 - $82 | 505% |
| Cmh Northern Lakes County | $72 - $82 | 505% |
| Cmh Ottawa County | $72 - $82 | 505% |
| Cmh Van Buren County | $72 - $82 | 505% |
| Cmh West Mi County | $72 - $82 | 505% |
| Magellan Behavioral Health | $72 - $82 | 505% |
| Priority Health | $79 - $81 | 554% |