CMS Price Transparency Data

Hepatitis C antibody test

Facility: Merit Health River Oaks

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $8
  • Cash Discount Price: $2
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Merit Health River Oaks is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.56x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$2

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $2 (14%)
Insurance Median: $8 (56%)
Cash: $2 (14% of Medicare)
Ins. Median: $8 (56% 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.

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
UnitedHealthcare $1 - $265 7%
Cigna $2 - $198 14%
Ms State Hospital Of Whitfield Ms $2 - $378 14%
Self Pay $2 - $219 14%
Trimed Billing Solutions $2 - $298 14%
First Choice Coventry $3 - $517 21%
First Choice Standard $3 - $457 21%
Aetna $4 - $500 28%
First Choice Mpcn Standard $4 - $547 28%
First Choice Ppo Plus $4 - $547 28%
Phcs $4 - $596 28%
American Health Group $5 - $845 35%
Beech Street $5 - $845 35%
Benefit Administration Services $5 - $845 35%
Benefit Management Systems $5 - $845 35%
Citizens State Bank Inc $5 - $845 35%
First Choice Stratose $5 - $795 35%
Formost $5 - $845 35%
Prime Health Services $5 - $795 35%
Tricare $5 - $13 35%
Usa Mco $5 - $845 35%
Advanced Health Systems $6 - $23 42%
Blue Cross Blue Shield $6 - $24 42%
Humana $6 - $14 42%
Medicaid / KanCare $6 - $14 42%
Medicare (plans) $6 - $14 42%
Molina $6 - $14 42%
Molina Exchange $6 - $25 42%
Ms Dept Of Rehabilitation Services $6 - $994 42%
Node Champva $6 - $14 42%
Node Devoted Health Mcr Adv $6 - $14 42%
Node First Choice American Health Mcr Adv $6 - $14 42%
Node First Choice Seven Corners $6 - $24 42%
Node First Choice Shared Health Of Ms Mcr Adv $6 - $14 42%
Node Hospice Non Par Agree $6 - $14 42%
Node Va $6 - $14 42%
Node Vantage Health Mcr Adv $6 - $14 42%
One Health Plan $6 - $895 42%
Veterans Eval Services $6 - $14 42%
Node First Choice Wellcare Mcr Adv $7 - $15 49%
Node Healthy Mississippi Mcr Adv $7 - $16 49%
Node Us Dept Of Labor $8 - $18 56%
First Choice Preferred $10 - $21 70%
Node First Choice Occunet $10 - $21 70%
Magnolia Exchange $11 - $25 77%
Caresource Truecare $13 91%
Magnolia Mcd Chip $13 91%
First Choice Lgp $14 - $31 98%
Molina Chip $14 98%
Vantage Health Commercial $14 - $32 98%
Ms Work Comp $26 182%
Prime Health Wc $26 182%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals