CMS Price Transparency Data

Hepatitis C antibody test

Facility: Lafayette Regional Health Center

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $79
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 5.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Lafayette Regional Health Center is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.54x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$79

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: $185 (1296%)
Insurance Median: $79 (554%)
Cash: $185 (1296% of Medicare)
Ins. Median: $79 (554% 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 554% of the Medicare baseline (a markup of 454%). 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
Aetna $13 - $162 91%
United $14 - $83 98%
Amerigroup $15 105%
Healthyblue $15 105%
Home State Health Plan $15 105%
Medicaid / KanCare $15 105%
Unicare $15 105%
Corvel Corporation $31 - $157 217%
Oha Network $31 - $92 217%
Ambetter / Centene $34 238%
Nhc Advantage $35 245%
Universal Healthcare $48 336%
Humana $62 - $79 434%
Blue Cross Blue Shield $70 - $185 491%
College Park Family Care Center $79 554%
Oscar $92 645%
Cigna $105 - $132 736%
Wppa Providrs Care Network $138 967%
Multiplan $144 1009%
Coventry $147 1030%
Coventry Kc Mo $147 1030%
Cco, Inc. $157 1100%
Focus Healthcare Mgmt, Inc $166 1163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals