CMS Price Transparency Data

Hepatitis C antibody test

Facility: Ohiohealth Morrow County Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86803
Insurance Median: $29
Cash Discount Price: $72
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Hepatitis C antibody test at Ohiohealth Morrow County Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 2.03x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $72 (505%)

Insurance Median: $29 (203%)

Cash: $72 (505% of Medicare)

Ins. Median: $29 (203% 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 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$6 - $71	42%
Aetna	$11 - $164	77%
Humana	$11 - $178	77%
Medicare (plans)	$11 - $72	77%
UnitedHealthcare	$11 - $156	77%
Caresource Marketplace - All Other Plans	$14 - $88	98%
Medical Mutual Of Ohio Marketplace	$22 - $143	154%
Ohiohealthy Network - All Other Plans	$22 - $143	154%
Ohiohealthy Preferred	$22 - $143	154%
Medical Mutual Of Ohio Comm - All Other Plans	$24 - $155	168%
Medical Mutual Of Ohio - Admin Serv	$25 - $162	175%
Phcs - All Plans	$27 - $176	189%
Cigna	$28 - $180	196%
Medicaid / KanCare	$28 - $29	196%
Multiplan - All Plans	$28 - $181	196%
Amerihealth Caritas - All Plans	$29	203%
Beech Street - All Plans	$29 - $185	203%
Healthstar Comm - All Plans	$29 - $183	203%
Molina Exchange - All Other Plans	$47	329%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $72.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86803.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ohiohealth Morrow County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86803.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.