CMS Price Transparency Data
Blood test, hemoglobin
Facility: Mercy Hospital Waldron
Billing Code: 85018 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85018
- Insurance Median: $12
- Cash Discount Price: $27
- vs. Medicare Baseline: 5.06x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Mercy Hospital Waldron is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 5.06x the Medicare baseline. Located in 1341 West Sixth Street, Waldron, AR.
Cash / Self-Pay
$27
Average discount available for prompt cash payment at this facility.
Insurance Median
$12
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$2.37
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $27 (1139%)
Insurance Median: $12 (506%)
Cash: $27 (1139% of Medicare)
Ins. Median: $12 (506% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $2.37 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 506% of the Medicare baseline (a markup of 406%). 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 | $2 - $27 | 84% |
| Humana | $2 - $36 | 84% |
| Medicaid / KanCare | $2 - $16 | 84% |
| United Medical Resources Contracted [320454] | $2 | 84% |
| UnitedHealthcare | $2 - $12 | 84% |
| Summit Community Care Contracted [320368] | $3 | 127% |
| Blue Cross Blue Shield | $4 - $12 | 169% |
| Usable Contracted [320409] | $4 | 169% |
| Novasys Contracted [320285] | $6 - $16 | 253% |
| Arkansas Total Care Contracted [320039] | $8 | 338% |
| Qual Choice Contracted [320324] | $10 | 422% |
| American Health Advantage Of Mo Mcr [20264] | $11 - $12 | 464% |
| Cherokee Nation Health Serv Contracted [320066] | $11 - $12 | 464% |
| Cross Timbers Hospice [20098] | $11 - $12 | 464% |
| Dept Of Veteran Affairs Contracted [320106] | $11 - $12 | 464% |
| Elara Caring Aspire Hospice Contracted [320433] | $11 - $12 | 464% |
| Elara Caring Aspire Hospice [20433] | $11 - $12 | 464% |
| Globalhealth Contracted [320145] | $11 - $12 | 464% |
| Halo Hcr Inc Hospice Contracted [320432] | $11 - $12 | 464% |
| Halo Hcr Inc Hospice [20432] | $11 - $12 | 464% |
| Independent Health [20197] | $11 - $12 | 464% |
| Indian Health Service Contracted [320198] | $11 - $12 | 464% |
| Indian Health Service [20198] | $11 - $12 | 464% |
| Jordan Valley Senior Care Pace [20515] | $11 - $12 | 464% |
| Kindful Hospice Contracted [320434] | $11 - $12 | 464% |
| Kindful Hospice [20434] | $11 - $12 | 464% |
| Medical Associates Health [20444] | $11 - $12 | 464% |
| Medicare (plans) | $11 - $12 | 464% |
| Mercy Hospice Okc [20252] | $11 - $12 | 464% |
| Pace Of The Ozarks [20518] | $11 - $12 | 464% |
| Provider Partners Health Plans Contracted [320450] | $11 - $12 | 464% |
| Qual Choice Contracted [320325] | $11 - $12 | 464% |
| Spina Bifida Hlthcare Benefit [20506] | $11 - $12 | 464% |
| Tricare | $11 | 464% |
| Valir Pace [20503] | $11 - $12 | 464% |
| Cigna | $12 - $36 | 506% |
| Ambetter / Centene | $16 | 675% |
| Home State Health Plan Contracted [320187] | $16 | 675% |
| Mercy Interfacility [20513] | $18 - $19 | 759% |
| Auxiant Contracted [320462] | $25 - $38 | 1055% |
| Mercy Benefit Admin Contracted [320251] | $25 - $38 | 1055% |
| Workers Comp [20426] | $27 | 1139% |
| 90 Degree Benefits Contracted [320436] | $35 - $36 | 1477% |
| Aither Health Contracted [320449] | $35 - $36 | 1477% |
| Ebms Contracted [320493] | $35 - $36 | 1477% |
| Edison Health Solutions Contracted [320502] | $35 - $36 | 1477% |
| Healthlink Contracted [320179] | $35 - $38 | 1477% |
| Imagine 360 Contracted [320494] | $35 - $36 | 1477% |
| Multiplan Contracted [320270] | $35 - $36 | 1477% |
| Multiplan [20270] | $35 - $36 | 1477% |
| Municipal Health Plan Contracted [320271] | $35 - $36 | 1477% |
| Reflect Health Contracted [320492] | $35 - $36 | 1477% |
| Show-Me Health Administrators Contracted [320483] | $35 - $36 | 1477% |
| Federal Medical Center Contracted [320127] | $37 - $38 | 1561% |
| Healthscope Contracted [320182] | $37 - $38 | 1561% |
| Insurance System Inc Contracted [320465] | $37 - $38 | 1561% |
| Personify Health Contracted [320051] | $37 - $38 | 1561% |
| Point C Contracted [320238] | $37 - $38 | 1561% |
| Preferred Health Plan Contracted [320522] | $37 - $38 | 1561% |
| Tri State Healthcare Coalition Contracted [320379] | $37 - $38 | 1561% |