CMS Price Transparency Data
Hepatitis C antibody test
Facility: Mercy Rehabilitation Hospital Springfield
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $54
- Cash Discount Price: $57
- vs. Medicare Baseline: 3.78x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Rehabilitation Hospital Springfield is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 3.78x the Medicare baseline. Located in 5904 S Southwood Rd, Springfield, MO.
Cash / Self-Pay
$57
Average discount available for prompt cash payment at this facility.
Insurance Median
$54
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: $57 (399%)
Insurance Median: $54 (378%)
Cash: $57 (399% of Medicare)
Ins. Median: $54 (378% 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 378% of the Medicare baseline (a markup of 278%). 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.
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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 | $33 - $60 | 231% |
| Blue Preferred | $39 - $43 | 273% |
| Firsthealth Network | $40 - $44 | 280% |
| Blue Cross Blue Shield | $41 - $60 | 287% |
| Healthlink Workcomp | $46 - $51 | 322% |
| Allwell From Home State Health | $54 - $60 | 378% |
| Allyalign Health (Nhc Advantage) | $54 - $60 | 378% |
| Ambetter / Centene | $54 - $60 | 378% |
| Architectural Systems, Inc. (Asi) | $54 - $60 | 378% |
| Ava R1 School District (Smbc) | $54 - $60 | 378% |
| Bakersfield School District (Smbc) | $54 - $60 | 378% |
| Blue Access | $54 - $60 | 378% |
| Bolivar School (Smbc) | $54 - $60 | 378% |
| Buchheit | $54 - $60 | 378% |
| Cardinal Scale (Tri State Healthcare Coalition) | $54 - $60 | 378% |
| Carthage R-9 School District (Tri-State Healthcare Coalition) | $54 - $60 | 378% |
| Cigna | $54 - $60 | 378% |
| City Of Springfield | $54 - $60 | 378% |
| City Of Webb City (Tri State Healthcare Coalition) | $54 - $60 | 378% |
| Devoted Healthcare | $54 - $60 | 378% |
| Diversified Plastics | $54 - $60 | 378% |
| Dora School District (Smbc) | $54 - $60 | 378% |
| Easter Seals Midwest | $54 - $60 | 378% |
| Employers Benefit Alliance | $54 - $60 | 378% |
| Essence | $54 - $60 | 378% |
| Evolutions | $54 - $60 | 378% |
| Fabick Cat | $54 - $60 | 378% |
| Fair Grove School District (Smbc) | $54 - $60 | 378% |
| Health Net Federal Services | $54 - $60 | 378% |
| Health Systems, Inc. | $54 - $60 | 378% |
| Healthlink Hmo | $54 - $60 | 378% |
| Healthlink Ppo | $54 - $60 | 378% |
| Heart Of America (Tri State Healthcare Coalition &Amp;#8211; Med Pay) | $54 - $60 | 378% |
| Hickory County Skyline School District (Smbc) | $54 - $60 | 378% |
| Home State Health Plan, Inc. | $54 - $60 | 378% |
| Humana | $54 - $60 | 378% |
| J And M Farms, Inc. (Tri-State Healthcare Coalition) | $54 - $60 | 378% |
| Jayhawk Fine Chemicals/Evonic(Tri State Healthcare Coalition) | $54 - $60 | 378% |
| Laclede County School District Conway (Smbc) | $54 - $60 | 378% |
| Lebanon School District (Smbc) | $54 - $60 | 378% |
| Liberty Utilities (Empire District Electric) | $54 - $60 | 378% |
| Marshfield School District (Smbc) | $54 - $60 | 378% |
| Medica | $54 - $60 | 378% |
| Medicaid / KanCare | $54 - $60 | 378% |
| Mercy Charity Contract | $54 - $60 | 378% |
| Mers Goodwill | $54 - $60 | 378% |
| Missouri State University | $54 - $60 | 378% |
| Mount Vernon School District (Smbc) | $54 - $60 | 378% |
| Mountain Grove R-111 School District (Smbc) | $54 - $60 | 378% |
| Mountain View School District (Smbc) | $54 - $60 | 378% |
| Multiplan/Phcs/Beech Street | $54 - $60 | 378% |
| Ozarks Community Hospital | $54 - $60 | 378% |
| Pathway/Pathway X | $54 - $60 | 378% |
| Phcs Savility | $54 - $60 | 378% |
| Quality Collisson Group | $54 - $60 | 378% |
| Quiktrip Corporation | $54 - $60 | 378% |
| Richards R-V School District (Smbc) | $54 - $60 | 378% |
| Roper Automotive Group (Tri State Healthcare Coalition) | $54 - $60 | 378% |
| S And H Farm Supply | $54 - $60 | 378% |
| Schreiber Foods | $54 - $60 | 378% |
| Shinesolar | $54 - $60 | 378% |
| Springfield Public Schools | $54 - $60 | 378% |
| Springfield Remanufacturing | $54 - $60 | 378% |
| Trailiner | $54 - $60 | 378% |
| UnitedHealthcare | $54 - $60 | 378% |
| Webb City R-Vii School District (Tri-State Healthcare Coalition) | $54 - $60 | 378% |
| Wellcare Health Plans | $54 - $60 | 378% |
| Woodard Cleaning &Amp;#038; Restoration, Inc. | $54 - $60 | 378% |