CMS Price Transparency Data

Hepatitis C antibody test

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 86803 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86803
  • Insurance Median: $70
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 4.91x Medicare
The contracted insurance negotiated median rate for a Hepatitis C antibody test at Mercy Hospital Tishomingo Inc is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $14.27, this hospital’s rate is 4.91x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $92 (645%)
Insurance Median: $70 (491%)
Cash: $92 (645% of Medicare)
Ins. Median: $70 (491% 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 491% of the Medicare baseline (a markup of 391%). 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
Aetna $13 - $94 91%
Humana $13 - $113 91%
Medicaid / KanCare $13 - $42 91%
Health Choice Contracted [320166] $19 133%
Blue Cross Blue Shield $38 - $68 266%
Ambetter / Centene $42 294%
Home State Health Plan Contracted [320187] $42 294%
Novasys Contracted [320285] $42 294%
Webtpa Contracted [320417] $59 413%
Medicare (plans) $65 - $90 456%
Cherokee Nation Health Serv Contracted [320066] $68 477%
Cross Timbers Hospice [20098] $68 477%
Dept Of Veteran Affairs Contracted [320106] $68 477%
Elara Caring Aspire Hospice Contracted [320433] $68 477%
Elara Caring Aspire Hospice [20433] $68 477%
Halo Hcr Inc Hospice Contracted [320432] $68 477%
Halo Hcr Inc Hospice [20432] $68 477%
Independent Health [20197] $68 477%
Indian Health Service Contracted [320198] $68 477%
Kindful Hospice Contracted [320434] $68 477%
Kindful Hospice [20434] $68 477%
Medical Associates Health [20444] $68 477%
Mercy Hospice Okc [20252] $68 477%
Provider Partners Health Plans Contracted [320450] $68 477%
Qual Choice Contracted [320325] $68 477%
Tribute Health Plan Mcr Contracted [320338] $68 477%
Tricare $68 477%
UnitedHealthcare $68 - $111 477%
Globalhealth Contracted [320145] $69 484%
Cigna $70 - $106 491%
Aither Health Contracted [320449] $85 - $120 596%
Mercy Benefit Admin Contracted [320251] $85 - $120 596%
Quik Trip Contracted [320447] $85 596%
Show-Me Health Administrators Contracted [320483] $85 596%
Medica Contracted [320239] $90 631%
First Health Contracted [320128] $94 659%
Osma Health Contracted [320292] $99 694%
Benefit Management Contracted [320052] $106 - $127 743%
Healthcare Highways Plus Contracted [320175] $106 743%
Private Health Care Systems Contracted [320320] $106 - $113 743%
United Medical Resources Contracted [320454] $111 778%
Multiplan Contracted [320270] $113 - $127 792%
Auxiant Contracted [320462] $120 841%
Ebms Contracted [320493] $120 841%
Healthlink Contracted [320179] $120 841%
Imagine 360 Contracted [320494] $120 841%
Preferred Community Choice Contracted [320311] $120 841%
Reflect Health Contracted [320492] $120 841%
Yuzu Health Contracted [320521] $120 841%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals