CMS Price Transparency Data
Hepatitis C antibody test
Facility: Mercy Medical Center
Billing Code: 86803 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86803
- Insurance Median: $14
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 0.98x the Medicare baseline. Located in 1000 North Village Avenue, Rockville Centre, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$14
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%)
Insurance Median: $14 (98%)
Ins. Median: $14 (98% 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
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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 |
|---|---|---|
| Affinity Health Plan | $10 - $23 | 70% |
| Beacon Health Options | $10 - $20 | 70% |
| Beacon Health Strategies | $10 - $20 | 70% |
| Centerlight Healthcare | $10 - $14 | 70% |
| Elderplan Inc. | $10 - $14 | 70% |
| Emblem Health | $10 - $32 | 70% |
| Fidelis Care New York | $10 - $23 | 70% |
| Health First | $10 - $32 | 70% |
| Health Plus | $10 - $23 | 70% |
| Independent Health | $10 - $14 | 70% |
| Medicaid / KanCare | $10 | 70% |
| Mvp Health Plans | $10 - $36 | 70% |
| Senior Whole Health | $10 - $14 | 70% |
| UnitedHealthcare | $10 - $53 | 70% |
| Aetna | $14 - $20 | 98% |
| Blue Cross Blue Shield | $14 - $53 | 98% |
| Centers Plan For Healthy Living | $14 | 98% |
| Healthspring | $14 | 98% |
| Liberty Health | $14 | 98% |
| Longevity Health Plan | $14 | 98% |
| Medicare (plans) | $14 - $15 | 98% |
| Orthonet - Uniformed Services Family Health Plan | $14 | 98% |
| Pmc | $14 | 98% |
| Surest | $14 | 98% |
| Tricare | $14 | 98% |
| Universal Healthcare | $14 | 98% |
| Us Family Health Plan | $14 | 98% |
| Veterans Affairs | $14 | 98% |
| Agewell New York | $15 | 105% |
| Humana | $15 | 105% |
| Partners Health Plan | $15 | 105% |
| Wellcare Health Plan Inc | $16 | 112% |
| Zadroga | $19 | 133% |
| Mail Handlers Benefit Plan | $20 | 140% |
| Meritain Health | $20 | 140% |
| Nippon Life Insurance Company Of America | $20 | 140% |
| Salvation Army | $20 | 140% |
| Centivo | $21 - $36 | 147% |
| American Plan Administrators | $32 | 224% |
| Amerihealth Administrators | $32 | 224% |
| Benefit Services | $32 | 224% |
| Ghi Cbp Ny City Employee Alternate | $32 | 224% |
| International Benefit Administrator | $32 | 224% |
| Ultra Benefits Inc. | $32 | 224% |
| Apwu | $36 | 252% |
| Cigna | $36 - $240 | 252% |
| Daniel H Cook | $36 | 252% |
| Nalc | $36 | 252% |
| Samba | $36 | 252% |
| Brighton | $37 - $258 | 259% |
| Self Pay | $53 | 371% |
| Local 1199 | $80 | 561% |
| Oscar Health | $151 | 1058% |
| Allied Wellfare Fund | $240 | 1682% |
| American Group Administrators | $240 | 1682% |
| Bakery & Confectionery Union | $240 | 1682% |
| Comprehensive Benefits Consultant | $240 | 1682% |
| Guardian Life Insurance Company Of America | $240 | 1682% |
| Maloney And Assoc | $240 | 1682% |
| Multiplan | $240 | 1682% |
| Performax | $240 | 1682% |
| Phcs | $240 | 1682% |
| Pomco | $240 | 1682% |
| Tpa Inc | $240 | 1682% |
| Unicare | $240 | 1682% |
| United Employees Health Plan | $240 | 1682% |
| Coventry | $273 - $295 | 1913% |
| Magellan | $295 | 2067% |
| Galaxy | $332 | 2327% |
| Three Rivers Provider Network | $332 | 2327% |
| Aither Health | $369 | 2586% |
| Alpha Care | $369 | 2586% |
| Dentaquest | $369 | 2586% |