CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercy Health Rehabilitation Hospital

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $79
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 5.54x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Health Rehabilitation Hospital is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 5.54x the Medicare baseline. Located in 3180 Belmont Ave, Youngstown, OH.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$79

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: $116 (813%)
Insurance Median: $79 (554%)
Cash: $116 (813% of Medicare)
Ins. Median: $79 (554% 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 554% of the Medicare baseline (a markup of 454%). 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
Medical Mutual Nas $38 - $89 266%
Aultcare $47 - $111 329%
Multiplan $57 - $137 399%
Aetna $68 - $163 477%
Ambetter / Centene $68 - $163 477%
Blue Cross Blue Shield $68 - $163 477%
Caresource Exchange $68 - $163 477%
Cigna $68 - $163 477%
Devoted $68 - $163 477%
Highmark Ppo Commercial $68 - $163 477%
Highmark Ppo Exchange $68 - $163 477%
Humana $68 - $163 477%
Medicaid / KanCare $68 - $163 477%
Medical Mutual Exchange $68 - $163 477%
Medical Mutual Medflex $68 - $163 477%
Medical Mutual New Biz $68 - $163 477%
Medical Mutual Supermed Commercial $68 - $163 477%
Medical Mutual Traditional Commercial $68 - $163 477%
Medicare (plans) $68 - $163 477%
Molina Exchange $68 - $163 477%
UnitedHealthcare $68 - $163 477%
Upmc $68 - $163 477%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3180 Belmont Ave, Youngstown, OH 44505
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL