CMS Price Transparency Data

Blood test, hemoglobin

Facility: John Muir Medical Center - Walnut Creek Campus

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $60
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 25.32x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at John Muir Medical Center - Walnut Creek Campus is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 25.32x the Medicare baseline. Located in 1601 Ygnacio Valley Rd, Walnut Creek, CA.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $47 (1983%)
Insurance Median: $60 (2532%)
Cash: $47 (1983% of Medicare)
Ins. Median: $60 (2532% 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 2532% of the Medicare baseline (a markup of 2432%). 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 - $184 84%
Alignment Health [1177113] $2 84%
Blue Cross Blue Shield $2 - $165 84%
Blue Shield-Network Mcare [1006127] $2 84%
Care 1St Health Plan [1094113] $2 84%
Caremore [1171113] $2 84%
Contra Costa County Jail [1012104] $2 84%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $2 84%
Easy Choice Health Plan [1083113] $2 84%
Essence Healthcare [1049028] $2 84%
Essence Healthcare [1049128] $2 84%
Golden State-Network Mcare [1023127] $2 84%
Health Net-Network Mcare [1028127] $2 84%
Hospice Of East Bay [1085104] $2 84%
Humana $2 - $211 84%
Medicare (plans) $2 - $203 84%
Scan-Network Mcare [1043127] $2 84%
UnitedHealthcare $2 - $148 84%
Veterans Administration [1051113] $2 84%
Generic Commercial/Indemnity [1017001] $3 - $102 127%
Generic Hmo [1018103] $3 127%
Generic Ppo [1021104] $3 127%
Jmpn Canopy Hn [1640000011] $3 127%
Canopy Hn Hmo [1166103] $4 169%
Brms [1091104] $32 1350%
Delta Health Systems [1032104] $32 1350%
Empire Plan [1092104] $32 1350%
Healthcomp [1089104] $32 - $216 1350%
Carecentrix [1011001] $33 - $102 1392%
Aps Healthcare [1003103] $37 - $114 1561%
Cigna $42 - $182 1772%
United Behavioral Health [1048103] $42 - $128 1772%
Carelon Behavioral Health [1050104] $46 - $140 1941%
Fortified Provider Network [1063104] $46 - $140 1941%
Medigap [1036001] $46 - $140 1941%
Three Rivers Provider Network [1073104] $46 - $140 1941%
Health Net Hmo [1028103] $48 - $145 2025%
Health Net-Network [1028026] $48 - $145 2025%
Contra Costa Health Plan Hmo [1013103] $50 - $152 2110%
Blue Shield Hmo [1006103] $52 - $161 2194%
Blue Shield-Network [1006026] $52 - $161 2194%
Blue Shield Ppo [1006104] $55 - $187 2321%
Western Health Advantage Hmo [1053103] $58 - $203 2447%
Health Net Ppo [1028104] $61 - $184 2574%
Federal Correction Institute [1062104] $67 - $203 2827%
First Health [1016104] $67 - $216 2827%
Healthsmart - Pka Interplan [1031104] $67 - $203 2827%
Kaiser Hmo [1033103] $67 - $206 2827%
National Provider Network/Plancare America [1069104] $67 - $203 2827%
Networks By Design [1084104] $67 - $203 2827%
Pponext [1072104] $67 - $203 2827%
Sutter Preferred Health Plan [1044104] $67 - $203 2827%
Health Management Network [1066104] $71 - $216 2996%
Galaxy Health Network [1064104] $75 - $229 3165%
Integrated Health Plan [1075104] $75 - $229 3165%
Donor Network West [1008103] $4,000 - $8,000 168776%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1601 Ygnacio Valley Rd, Walnut Creek, CA 94598
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals