CMS Price Transparency Data

Blood test, hemoglobin

Facility: Adventist Health St Helena

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $4
Cash Discount Price: $11
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Adventist Health St Helena is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 1.69x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$11

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $11 (464%)

Insurance Median: $4 (169%)

Cash: $11 (464% of Medicare)

Ins. Median: $4 (169% 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.

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
Choicecare-All Plans	$1 - $93	42%
Interplan-All Plans	$1 - $86	42%
Phcs-All Plans	$1 - $73	42%
UnitedHealthcare	$1 - $85	42%
Western Growers-All Plans	$1 - $70	42%
Beech Street-All Plans	$2 - $100	84%
Blue Shield Bh Mcr Adv	$2	84%
Blue Shield Mcr Adv	$2	84%
Cigna	$2 - $106	84%
Galaxy Network-All Plans	$2 - $120	84%
Health Management Network-All Plans	$2 - $113	84%
Kaiser Mcr Adv	$2	84%
Kaiser-All Other Plans	$2 - $109	84%
Three Rivers-All Plans	$2 - $120	84%
Tricare	$2	84%
Va Mcr - All Other Plans	$2	84%
Va Medi-Cal	$2 - $3	84%
Blue Shield Behav Hlth	$3 - $60	127%
Blue Shield Epn-All Other Plans	$3 - $63	127%
Blue Shield Non-Epn	$3 - $62	127%
Healthnet-All Plans	$3	127%
Ah Employee Health Plan - All Plans	$4	169%
Aetna	$14	591%
Blue Cross Blue Shield	$20 - $27	844%

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 $11.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85018.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85018.
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.