CMS Price Transparency Data

Blood test, hemoglobin

Facility: Seneca District Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $22
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 9.28x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Seneca District Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 9.28x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $19 (802%)
Insurance Median: $22 (928%)
Cash: $19 (802% of Medicare)
Ins. Median: $22 (928% 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 928% of the Medicare baseline (a markup of 828%). 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
Ambetter / Centene $3 127%
Amthem Bc Mcal $3 127%
Medi-Cal $3 127%
Partnership Hp-All Plans $3 127%
UnitedHealthcare $9 - $23 380%
Tricare $16 675%
Blue Cross Blue Shield $19 - $21 802%
Imperial Hp Ma-All Plans $19 802%
Blue Shield Ipf/Ca Exchange $21 886%
Beech Street Corp- All Plans $22 928%
Cigna $22 928%
Integrated Hp-All Plans $22 928%
Interplan Corp- All Plans $22 928%
Medincrease- All Plans $22 928%
Multiplan- All Plans $22 928%
Pacificare - All Plans $22 928%
Provider Ntwrk Of America-All Plans $22 928%
Alliance- All Plans $23 970%
Blue Shield Of Ca- All Other Plans $23 970%
Community Care Network - All Plans $23 970%
Coventry- All Plans $23 970%
Healthnet - All Other Plans $23 970%
Northern Nevada Health Network- All Plans $23 970%
Superior California Ppo - All Plans $23 970%
Three Rivers- All Plans $23 970%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Brentwood Drive, Chester, CA 96020
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals