CMS Price Transparency Data

Blood test, hemoglobin

Facility: Good Samaritan Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $12
  • Cash Discount Price: $186
  • vs. Medicare Baseline: 5.06x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Good Samaritan Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $186. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 5.06x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.
Cash / Self-Pay
$186

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: $186 (7848%)
Insurance Median: $12 (506%)
Cash: $186 (7848% 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 - $12 84%
Affinity Medical Group $2 84%
Alignment Health Plan $2 84%
Blue Cross Blue Shield $2 - $12 84%
Blue Shield $2 - $4 84%
Care1St Health Plan $2 84%
Central Health Plan $2 84%
Clever Care Of Golden State $2 84%
Easy Choice Health Plan $2 84%
Humana $2 - $208 84%
Managed Health Network $2 84%
On Lok Senior Health $2 84%
Palo Alto Medical $2 - $3 84%
Santa Clara Family Health Plan $2 - $56 84%
Scan Health Plan $2 84%
Triwest Healthcare Alliance $2 84%
United $2 - $76 84%
University Healthcare $2 84%
Vitality Health Plan $2 84%
Affinity Medical Group Comm $3 127%
Corvel Corporation $3 127%
Health Net $3 - $69 127%
Physicians Medical Group $3 127%
Canopy $4 169%
Bright Health $5 211%
Medcare Partners $11 - $44 464%
Cigna $25 - $237 1055%
Nx Health Network $45 - $178 1899%
Sutter Select $45 - $178 1899%
Multiplan $49 - $237 2068%
First Health $57 - $296 2405%
Healthsmart $60 - $237 2532%
Intercontinental Corporation $60 - $237 2532%
Pha Pacific Health Alliance $60 - $237 2532%
Ppo Next $60 - $237 2532%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2425 Samaritan Drive, San Jose, CA 95124
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals