CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercy St Francis Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $192
  • Cash Discount Price: $138
  • vs. Medicare Baseline: 13.45x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy St Francis Hospital is $192. 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 13.45x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$138

Average discount available for prompt cash payment at this facility.

Insurance Median
$192

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: $192 (1345%)
Cash: $138 (967% of Medicare)
Ins. Median: $192 (1345% 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 1345% of the Medicare baseline (a markup of 1245%). 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
Blue Cross Blue Shield $14 - $207 98%
Medicaid / KanCare $14 - $111 98%
UnitedHealthcare $14 - $202 98%
Medicare (plans) $15 - $76 105%
Tricare $72 505%
Aetna $73 - $190 512%
Cherokee Nation Health Serv Contracted [320066] $73 512%
Cigna $73 - $202 512%
Cross Timbers Hospice [20098] $73 512%
Dept Of Veteran Affairs Contracted [320106] $73 512%
Elara Caring Aspire Hospice [20433] $73 512%
Globalhealth Contracted [320145] $73 512%
Halo Hcr Inc Hospice Contracted [320432] $73 512%
Halo Hcr Inc Hospice [20432] $73 512%
Humana $73 - $192 512%
Indian Health Service Contracted [320198] $73 512%
Kindful Hospice Contracted [320434] $73 512%
Kindful Hospice [20434] $73 512%
Medical Associates Health Contracted [320444] $73 512%
Mercy Hospice Okc [20252] $73 512%
Mercy Mgd Behavioral Health Contracted [320259] $73 512%
Pace Of The Ozarks Contracted [320518] $73 512%
Provider Partners Health Plans Contracted [320450] $73 512%
Qual Choice Contracted [320325] $73 512%
Administrative Payor Contracted [320005] $96 673%
Healthscope Contracted [320182] $97 680%
Ambetter / Centene $111 778%
Home State Health Plan Contracted [320187] $111 778%
Novasys Contracted [320285] $111 778%
Centivo Contracted [320505] $124 869%
Healthlink Contracted [320179] $138 - $202 967%
Preferred Health Plan Contracted [320522] $138 967%
Workers Comp [20426] $170 - $181 1191%
Auxiant Contracted [320462] $192 - $202 1345%
Mercy Benefit Admin Contracted [320251] $192 - $202 1345%
Point C Contracted [320238] $192 - $202 1345%
United Medical Resources Contracted [320454] $192 - $198 1345%
Medica Contracted [320239] $201 1409%
90 Degree Benefits Contracted [320436] $202 1416%
Aither Health Contracted [320449] $202 1416%
Benefit Management Contracted [320052] $202 1416%
Ebms Contracted [320493] $202 1416%
Edison Health Solutions Contracted [320502] $202 1416%
Evolutions Health Care Contracted [320124] $202 1416%
First Health Contracted [320128] $202 1416%
Health Systems Inc Contracted [320174] $202 1416%
Imagine 360 Contracted [320494] $202 1416%
Insurance System Inc Contracted [320465] $202 1416%
Multiplan Contracted [320270] $202 1416%
Point C [20238] $202 1416%
Private Health Care Systems Contracted [320320] $202 1416%
Reflect Health Contracted [320492] $202 1416%
Show-Me Health Administrators Contracted [320483] $202 1416%
Usa Managed Care Org Contracted [320429] $202 1416%
Yuzu Health Contracted [320521] $202 1416%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Highway 60, Po Box 82, Mountain View, MO 65548
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals