CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercy Hospital - Cassville

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $170
Cash Discount Price: $138
vs. Medicare Baseline: 11.91x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Hospital - Cassville is $170. 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 11.91x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$138

Average discount available for prompt cash payment at this facility.

Insurance Median

$170

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: $170 (1191%)

Cash: $138 (967% of Medicare)

Ins. Median: $170 (1191% 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 1191% of the Medicare baseline (a markup of 1091%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$13 - $190	91%
Humana	$13 - $181	91%
Medicaid / KanCare	$13 - $111	91%
Blue Cross Blue Shield	$14 - $207	98%
Medicare (plans)	$15 - $91	105%
UnitedHealthcare	$20 - $202	140%
Dept Of Veteran Affairs Contracted [320106]	$73	512%
Tricare	$86	603%
Cherokee Nation Health Serv Contracted [320066]	$88	617%
Cigna	$88 - $202	617%
Cross Timbers Hospice [20098]	$88	617%
Elara Caring Aspire Hospice [20433]	$88	617%
Globalhealth Contracted [320145]	$88	617%
Halo Hcr Inc Hospice Contracted [320432]	$88	617%
Halo Hcr Inc Hospice [20432]	$88	617%
Indian Health Service Contracted [320198]	$88	617%
Kindful Hospice Contracted [320434]	$88	617%
Kindful Hospice [20434]	$88	617%
Medical Associates Health Contracted [320444]	$88	617%
Mercy Hospice Okc [20252]	$88	617%
Mercy Mgd Behavioral Health Contracted [320259]	$88	617%
Pace Of The Ozarks Contracted [320518]	$88	617%
Provider Partners Health Plans Contracted [320450]	$88	617%
Qual Choice Contracted [320325]	$88	617%
Healthscope Contracted [320182]	$89	624%
Administrative Payor Contracted [320005]	$96	673%
Centivo Contracted [320505]	$109	764%
Ambetter / Centene	$111	778%
Home State Health Plan Contracted [320187]	$111	778%
Novasys Contracted [320285]	$111	778%
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 - $192	1191%
Point C [20238]	$170	1191%
United Medical Resources Contracted [320454]	$170 - $181	1191%
Workers Comp [20426]	$170 - $192	1191%
Municipal Health Plan Contracted [320271]	$173	1212%
Medica Contracted [320239]	$191	1338%
90 Degree Benefits Contracted [320436]	$192	1345%
Aither Health Contracted [320449]	$192	1345%
American Healthcare Alliance Contracted [320020]	$192	1345%
Auxiant Contracted [320462]	$192	1345%
Benefit Management Contracted [320052]	$192	1345%
Ebms Contracted [320493]	$192	1345%
Edison Health Solutions Contracted [320502]	$192	1345%
Evolutions Health Care Contracted [320124]	$192	1345%
Imagine 360 Contracted [320494]	$192	1345%
Mercy Benefit Admin Contracted [320251]	$192	1345%
Reflect Health Contracted [320492]	$192	1345%
Show-Me Health Administrators Contracted [320483]	$192	1345%
Usa Managed Care Org Contracted [320429]	$192	1345%
Yuzu Health Contracted [320521]	$192	1345%
First Health Contracted [320128]	$202	1416%
Multiplan Contracted [320270]	$202	1416%
Private Health Care Systems Contracted [320320]	$202	1416%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $138.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital - Cassville is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.