CMS Price Transparency Data
Hepatitis C antibody test
Facility: Mercy Health Lakeshore Campus
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $64
- Cash Discount Price: $50
- vs. Medicare Baseline: 4.48x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Health Lakeshore Campus is $64. 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 4.48x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$50
Average discount available for prompt cash payment at this facility.
Insurance Median
$64
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: $64 (448%)
Cash: $50 (350% of Medicare)
Ins. Median: $64 (448% 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 448% of the Medicare baseline (a markup of 348%). 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 | $11 - $70 | 77% |
| Medicaid / KanCare | $11 | 77% |
| Access Health | $14 | 98% |
| Aetna | $14 - $65 | 98% |
| Align Senior Care | $14 | 98% |
| Blue Care Network Advantage | $14 | 98% |
| Correctional Recovery | $14 | 98% |
| Medicare (plans) | $14 - $20 | 98% |
| UnitedHealthcare | $14 - $74 | 98% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $16 | 112% |
| U Of M Health Plan | $17 - $73 | 119% |
| Oscar | $22 - $25 | 154% |
| Vitalcore | $22 | 154% |
| Wellpath | $22 | 154% |
| Molina Marketplace | $30 - $34 | 210% |
| Hospice Of Michigan | $40 - $45 | 280% |
| Nomi Health | $40 - $46 | 280% |
| Hap | $54 - $73 | 378% |
| Geha | $57 - $74 | 399% |
| Meritain | $57 - $65 | 399% |
| Wc Accident Fund | $57 - $65 | 399% |
| Wc Advantage | $57 - $65 | 399% |
| Wc Aig | $57 - $65 | 399% |
| Wc Allied | $57 - $65 | 399% |
| Wc Amerisure | $57 - $65 | 399% |
| Wc Amtrust | $57 - $65 | 399% |
| Wc Asu Risk Mgt | $57 - $65 | 399% |
| Wc Berkley Admin | $57 - $65 | 399% |
| Wc Broadspire | $57 - $65 | 399% |
| Wc Bunch & Associates | $57 - $65 | 399% |
| Wc Ccmsi | $57 - $65 | 399% |
| Wc Emc Insurance Company | $57 - $65 | 399% |
| Wc Esis | $57 - $65 | 399% |
| Wc Fcci | $57 - $65 | 399% |
| Wc Federated | $57 - $65 | 399% |
| Wc Gallagher Bassett | $57 - $65 | 399% |
| Wc Genex Care For Ohio | $57 - $65 | 399% |
| Wc Guard Insurance Company | $57 - $65 | 399% |
| Wc Hartford | $57 - $65 | 399% |
| Wc Liberty Mutual | $57 - $65 | 399% |
| Wc Meijers | $57 - $65 | 399% |
| Wc Michigan | $57 - $65 | 399% |
| Wc Mitchell Frankenmuth | $57 - $65 | 399% |
| Wc Pma | $57 - $65 | 399% |
| Wc Sedgwick | $57 - $65 | 399% |
| Wc Sentry | $57 - $65 | 399% |
| Wc Travelers | $57 - $65 | 399% |
| Wc Tristar | $57 - $65 | 399% |
| Wc Walmart | $57 - $65 | 399% |
| Wc Zurich | $57 - $65 | 399% |
| Asr Health Benefits | $60 - $68 | 420% |
| 1199 National Benefit Fund | $62 - $71 | 434% |
| Allied National Global Care | $62 - $71 | 434% |
| Asrm - Reliance Standard Life Insurance | $62 - $71 | 434% |
| Bcn Domestic | $62 - $70 | 434% |
| Blue Benefit Administrators Of Massachusetts | $62 - $70 | 434% |
| Blue Care Network | $62 - $70 | 434% |
| Blue Distinction Transplant | $62 - $70 | 434% |
| Blue Shield - Ca | $62 - $70 | 434% |
| Blue Shield - Id (Regence) | $62 - $70 | 434% |
| Blue Shield - Ny Highmark Northeastern | $62 - $70 | 434% |
| Blue Shield - Ny Highmark Western | $62 - $70 | 434% |
| Blue Shield - Pa (Highmark) | $62 - $70 | 434% |
| Blue Shield - Wa (Regence) | $62 - $70 | 434% |
| Christian Care Ministry | $62 - $71 | 434% |
| Cigna | $62 - $71 | 434% |
| Dean Health | $62 - $71 | 434% |
| Fallon Health | $62 - $71 | 434% |
| Family Life Insurance Company | $62 - $71 | 434% |
| Ghc Scw | $62 - $71 | 434% |
| Group Pension Administrators | $62 - $71 | 434% |
| Health Choices | $62 - $73 | 434% |
| International Benefit Administrators | $62 - $71 | 434% |
| Kaiser Domestic | $62 - $70 | 434% |
| Lifetime Benefit Solutions | $62 - $71 | 434% |
| Manhattan Life | $62 - $71 | 434% |
| Medi Share | $62 - $71 | 434% |
| Multiplan | $62 - $71 | 434% |
| Mvp | $62 - $71 | 434% |
| Pai | $62 - $71 | 434% |
| Pan-American Life | $62 - $71 | 434% |
| Paramount Hmo | $62 - $71 | 434% |
| Phcs | $62 - $71 | 434% |
| Trinity Health Share | $62 - $71 | 434% |
| Acclaim | $64 - $73 | 448% |
| Administrative Concepts | $64 - $73 | 448% |
| Allegeant | $64 - $73 | 448% |
| Allied Benefit Systems | $64 - $73 | 448% |
| Ameriben | $64 - $73 | 448% |
| American Family | $64 - $73 | 448% |
| American Healthcare Alliance | $64 - $73 | 448% |
| American Republic | $64 - $73 | 448% |
| Amerihealth | $64 - $73 | 448% |
| Aultcare | $64 - $73 | 448% |
| Automated Benefit Services | $64 - $73 | 448% |
| Auxiant | $64 - $73 | 448% |
| Benefit Administrative Systems,Llc | $64 - $73 | 448% |
| Boon Chapman | $64 - $73 | 448% |
| Cam Administrative Services | $64 - $73 | 448% |
| Caresource | $64 - $73 | 448% |
| Christian Brother Services | $64 - $73 | 448% |
| Christian Brothers Holy Cross | $64 - $73 | 448% |
| Claimchoice Adminstrators | $64 - $73 | 448% |
| Comprehensive Benefits | $64 - $73 | 448% |
| Consociate | $64 - $73 | 448% |
| Continental Life Insurance | $64 - $73 | 448% |
| Custom Benefit Administrators | $64 - $73 | 448% |
| Cypress Benefit Administrators | $64 - $73 | 448% |
| Employee Benefit Concepts | $64 - $73 | 448% |
| Employee Benefit Management | $64 - $73 | 448% |
| Enterprise Group Planning | $64 - $73 | 448% |
| Forest County Potawatomi | $64 - $73 | 448% |
| Freedom Life Insurance Company | $64 - $73 | 448% |
| Group Administrators | $64 - $73 | 448% |
| Group Marketing Services | $64 - $73 | 448% |
| Guardian | $64 - $73 | 448% |
| Health America | $64 - $73 | 448% |
| Health Smart | $64 - $73 | 448% |
| Healthez | $64 - $73 | 448% |
| Healthgram | $64 - $73 | 448% |
| Healthscope | $64 - $73 | 448% |
| Humana | $64 - $73 | 448% |
| Insight | $64 - $73 | 448% |
| Intercare | $64 - $73 | 448% |
| Jfp Benefit Management | $64 - $73 | 448% |
| Jp Farley Corporation | $64 - $73 | 448% |
| Key Benefit Administrator | $64 - $73 | 448% |
| Liberty Union Life Assurance Co | $64 - $73 | 448% |
| Lucent Health | $64 - $73 | 448% |
| Luminare Health | $64 - $73 | 448% |
| Luminare Health (Detroit) | $64 - $73 | 448% |
| Medben | $64 - $73 | 448% |
| Medcost | $64 - $73 | 448% |
| Medical Mutual | $64 - $73 | 448% |
| Mutual Health Services | $64 - $73 | 448% |
| Mutual Of Omaha | $64 - $73 | 448% |
| Ncas | $64 - $73 | 448% |
| Nippon Life Ins | $64 - $73 | 448% |
| Nova | $64 - $73 | 448% |
| Painters Union Insurance Fund | $64 - $73 | 448% |
| Physicians Mutual | $64 - $73 | 448% |
| Plumbers Local 98 Insurance Fund | $64 - $73 | 448% |
| Prairie States | $64 - $73 | 448% |
| Primary Physician Care | $64 - $73 | 448% |
| Professional Benefit Administrators | $64 - $73 | 448% |
| Secureone Preferred United Plans | $64 - $73 | 448% |
| The Loomis Company | $64 - $73 | 448% |
| Trustmark Small Business Benefits | $64 - $73 | 448% |
| Unicare | $64 - $73 | 448% |
| Unified Group Services | $64 - $73 | 448% |
| Us Health And Life | $64 - $73 | 448% |
| Valenz | $64 - $73 | 448% |
| Varipro | $64 - $73 | 448% |
| Western & Southern Financial Group | $64 - $73 | 448% |
| Wps | $64 - $73 | 448% |
| First Health | $65 - $74 | 456% |
| Priority Health | $65 - $74 | 456% |