CMS Price Transparency Data

Blood test, hemoglobin

Facility: Adventist Health Tulare

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $11
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 4.64x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Adventist Health Tulare is $11. 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 4.64x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$11

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $11 (464%)
Cash: $11 (464% of Medicare)
Ins. Median: $11 (464% 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 464% of the Medicare baseline (a markup of 364%). 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
Hs Interplan-All Plans $1 - $100 42%
Network By Design-All Plans $1 - $98 42%
UnitedHealthcare $1 - $109 42%
Blue Shield Mcare $2 84%
Ccipa Medi-Cal - All Plans $2 - $4 84%
Dignity Mcal Op Only $2 - $3 84%
Dignity Mcr Op Only - All Other Plans $2 84%
Fhcn Pace Mcr Adv - All Plans $2 84%
Healthnet Medi-Cal $2 - $4 84%
Independence Op Only - All Plans $2 - $3 84%
Medi-Cal $2 - $3 84%
Medicare (plans) $2 84%
Multiplan - All Plans $2 - $128 84%
Prime Health - All Plans $2 84%
Tricare $2 84%
Bright Health - All Plans $3 127%
Cal Forensic Med Grp - All Plans $3 127%
Prison Hlthcre - All Plans $3 127%
Ah Employee Health Plan - All Plans $4 169%
Incentive Hlth - All Plans $4 169%
Healthnet Hmo/Ppo - All Other Plans $6 253%
Blue Shield Epn $11 - $47 464%
Blue Shield-All Other Plans $15 - $66 633%
Western Growers - All Plans $16 - $69 675%
Aetna $20 844%
Blue Cross Blue Shield $22 - $24 928%
Cigna $26 - $69 1097%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals