CMS Price Transparency Data

Blood test, hemoglobin

Facility: Adventist Health Clearlake

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $52
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 21.94x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Adventist Health Clearlake is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 21.94x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $27 (1139%)
Insurance Median: $52 (2194%)
Cash: $27 (1139% of Medicare)
Ins. Median: $52 (2194% 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 2194% of the Medicare baseline (a markup of 2094%). 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
UnitedHealthcare $1 - $218 42%
Aetna $2 - $195 84%
Bc Managed Mcal $2 - $3 84%
Blue Shield Epn - All Other Plans $2 - $200 84%
Blue Shield Non-Epn $2 - $200 84%
Cigna $2 - $235 84%
First Health- All Plans $2 - $209 84%
Foundation- All Plans $2 - $222 84%
Health Mgmt Network- All Plans $2 - $222 84%
Healthnet- All Plans $2 - $214 84%
Humana $2 - $222 84%
Interplan- All Plans $2 - $235 84%
Kaiser- All Other Plans $2 - $235 84%
Medi-Cal $2 - $3 84%
Partnership Mcal - All Plans $2 - $3 84%
Phcs- All Plans $2 - $222 84%
Three Rivers Provider Network- All Plans $2 - $235 84%
Western Growers- All Plans $2 - $196 84%
Blue Shield Mcr Adv $12 - $55 506%
Kaiser Mcr Adv $12 - $55 506%
Tricare $12 - $55 506%
Blue Cross Blue Shield $13 - $57 549%
Ah Employee Health Plan - All Plans $24 - $110 1013%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15630 18Th Ave - Hwy 53, Clearlake, CA 95422
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals