CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercy Hospital Aurora

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $181
  • Cash Discount Price: $138
  • vs. Medicare Baseline: 12.68x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Hospital Aurora is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 12.68x the Medicare baseline. Located in 500 Porter Avenue, Aurora, MO.
Cash / Self-Pay
$138

Average discount available for prompt cash payment at this facility.

Insurance Median
$181

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: $138 (967%)
Insurance Median: $181 (1268%)
Cash: $138 (967% of Medicare)
Ins. Median: $181 (1268% 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 1268% of the Medicare baseline (a markup of 1168%). 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 $14 - $108 98%
Medicare (plans) $15 - $63 105%
Blue Cross Blue Shield $20 - $213 140%
UnitedHealthcare $20 - $202 140%
Aetna $61 - $190 427%
Cherokee Nation Health Serv Contracted [320066] $61 427%
Cigna $61 - $181 427%
Cross Timbers Hospice [20098] $61 427%
Elara Caring Aspire Hospice [20433] $61 427%
Globalhealth Contracted [320145] $61 427%
Halo Hcr Inc Hospice Contracted [320432] $61 427%
Halo Hcr Inc Hospice [20432] $61 427%
Humana $61 - $181 427%
Indian Health Service Contracted [320198] $61 427%
Kindful Hospice Contracted [320434] $61 427%
Kindful Hospice [20434] $61 427%
Medical Associates Health Contracted [320444] $61 427%
Mercy Hospice Okc [20252] $61 427%
Mercy Mgd Behavioral Health Contracted [320259] $61 427%
Pace Of The Ozarks Contracted [320518] $61 427%
Provider Partners Health Plans Contracted [320450] $61 427%
Qual Choice Contracted [320325] $61 427%
Dept Of Veteran Affairs Contracted [320106] $62 434%
Tricare $62 434%
Healthscope Contracted [320182] $78 547%
Centivo Contracted [320505] $85 596%
Administrative Payor Contracted [320005] $96 673%
Ambetter / Centene $108 757%
Home State Health Plan Contracted [320187] $108 757%
Novasys Contracted [320285] $108 757%
Healthlink Contracted [320179] $138 - $192 967%
Preferred Health Plan Contracted [320522] $138 967%
Health Systems Inc Contracted [320174] $170 1191%
Insurance System Inc Contracted [320465] $170 1191%
Point C Contracted [320238] $170 - $181 1191%
Point C [20238] $170 1191%
Workers Comp [20426] $170 - $181 1191%
Medica Contracted [320239] $180 1261%
90 Degree Benefits Contracted [320436] $181 1268%
Aither Health Contracted [320449] $181 1268%
American Healthcare Alliance Contracted [320020] $181 1268%
Auxiant Contracted [320462] $181 1268%
Benefit Management Contracted [320052] $181 1268%
Ebms Contracted [320493] $181 1268%
Edison Health Solutions Contracted [320502] $181 1268%
Evolutions Health Care Contracted [320124] $181 1268%
First Health Contracted [320128] $181 1268%
Imagine 360 Contracted [320494] $181 1268%
Mercy Benefit Admin Contracted [320251] $181 1268%
Reflect Health Contracted [320492] $181 1268%
Show-Me Health Administrators Contracted [320483] $181 1268%
United Medical Resources Contracted [320454] $181 - $187 1268%
Yuzu Health Contracted [320521] $181 1268%
Usa Managed Care Org Contracted [320429] $187 1310%
Multiplan Contracted [320270] $202 1416%
Private Health Care Systems Contracted [320320] $202 1416%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 Porter Avenue, Aurora, MO 65605
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals