CMS Price Transparency Data

Blood test, hemoglobin

Facility: Loma Linda University Children's Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $40
Cash Discount Price: $40
vs. Medicare Baseline: 16.88x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Loma Linda University Children's Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 16.88x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $40 (1688%)

Insurance Median: $40 (1688%)

Cash: $40 (1688% of Medicare)

Ins. Median: $40 (1688% 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 1688% of the Medicare baseline (a markup of 1588%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Alpha Care Medical Group	$2 - $4	84%
Dignity Health	$2 - $4	84%
Epic Health Plan	$2 - $38	84%
Inland Empire Health Plan (Iehp)	$2 - $3	84%
Kaiser Foundation Hospitals	$2 - $63	84%
UnitedHealthcare	$2	84%
Upland Medical Group	$2	84%
Vantage Medical Group	$2 - $4	84%
Molina Healthcare Of Ca	$3	127%
Heritage Provider Network	$4	169%
Adventist Health	$17 - $19	717%
Lluh Dept Of Risk Management	$20 - $23	844%
Blue Cross Blue Shield	$23	970%
Blue Shield Of California	$37 - $64	1561%
Global Benefits Group	$50 - $57	2110%
Temecula Valley Physicians Medical Group	$50 - $57	2110%
Trivalley Medical Group	$50 - $57	2110%
Cigna	$53 - $70	2236%
Aetna	$54 - $62	2278%
Networks By Design	$54 - $62	2278%
Multiplan	$66 - $76	2785%
Galaxy Health	$71 - $81	2996%
Prime Health Services	$71 - $81	2996%

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 $40.
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 Loma Linda University Children's Hospital 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.