CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercy Hospital Lebanon

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $100
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 7.01x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Hospital Lebanon is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 7.01x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $86 (603%)
Insurance Median: $100 (701%)
Cash: $86 (603% of Medicare)
Ins. Median: $100 (701% 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 701% of the Medicare baseline (a markup of 601%). 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
Medicaid / KanCare $13 - $31 91%
Aetna $14 - $100 98%
Blue Cross Blue Shield $14 - $140 98%
Champva [20065] $14 98%
Cherokee Nation Health Serv Contracted [320066] $14 98%
Cigna $14 - $98 98%
Cross Timbers Hospice [20098] $14 98%
Dept Of Veteran Affairs Contracted [320106] $14 98%
Elara Caring Aspire Hospice [20433] $14 98%
Globalhealth Contracted [320145] $14 98%
Halo Hcr Inc Hospice Contracted [320432] $14 98%
Halo Hcr Inc Hospice [20432] $14 98%
Humana $14 - $113 98%
Kindful Hospice Contracted [320434] $14 98%
Kindful Hospice [20434] $14 98%
Medica Contracted [320239] $14 98%
Medica [20239] $14 98%
Medicare (plans) $14 - $15 98%
Mercy Hospice Okc [20252] $14 98%
Mercy Mgd Behavioral Health Contracted [320259] $14 98%
Pace Of The Ozarks Contracted [320518] $14 98%
Provider Partners Health Plans Contracted [320450] $14 98%
Qual Choice Contracted [320325] $14 98%
Tricare $14 98%
UnitedHealthcare $14 - $126 98%
Healthscope Contracted [320182] $18 126%
United Medical Resources Contracted [320454] $18 - $106 126%
Centivo Contracted [320505] $24 168%
Ambetter / Centene $31 217%
Home State Health Plan Contracted [320187] $31 217%
Novasys Contracted [320285] $31 217%
Administrative Payor Contracted [320005] $60 420%
Healthlink Contracted [320179] $86 - $113 603%
Preferred Health Plan Contracted [320522] $86 603%
90 Degree Benefits Contracted [320436] $100 701%
Mercy Benefit Admin Contracted [320251] $100 - $106 701%
Show-Me Health Administrators Contracted [320483] $100 701%
Aither Health Contracted [320449] $106 743%
Auxiant Contracted [320462] $106 743%
Benefit Management Contracted [320052] $106 743%
Ebms Contracted [320493] $106 743%
Edison Health Solutions Contracted [320502] $106 743%
Evolutions Health Care Contracted [320124] $106 743%
First Health Contracted [320128] $106 743%
Health Systems Inc Contracted [320174] $106 743%
Imagine 360 Contracted [320494] $106 743%
Insurance System Inc Contracted [320465] $106 743%
Point C Contracted [320238] $106 - $126 743%
Point C [20238] $106 743%
Reflect Health Contracted [320492] $106 743%
Workers Comp [20426] $106 - $113 743%
Yuzu Health Contracted [320521] $106 743%
American Healthcare Alliance Contracted [320020] $113 792%
Usa Managed Care Org Contracted [320429] $117 820%
Multiplan Contracted [320270] $126 883%
Private Health Care Systems Contracted [320320] $126 883%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Hospital Drive, Lebanon, MO 65536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals