CMS Price Transparency Data

Blood test, hemoglobin

Facility: Modoc Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $55
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 23.21x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Modoc Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 23.21x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $63 (2658%)
Insurance Median: $55 (2321%)
Cash: $63 (2658% of Medicare)
Ins. Median: $55 (2321% 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 2321% of the Medicare baseline (a markup of 2221%). 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
Integrated Hp Wc $2 84%
Multiplan Wc $2 84%
Ntwrks By Design Wc - All Plans $2 84%
Adv Med Mgmt - All Plans $3 127%
Medi-Cal $3 127%
Medi-Cal 7/1/24 $3 127%
Partnership Hp - All Plans $3 127%
Blue Shield Mcr Adv $34 1435%
Blue Shield Va $34 1435%
UnitedHealthcare $34 - $60 1435%
Healthnet Mcr Adv $36 1519%
Tricare $36 1519%
Blue Cross Blue Shield $52 - $58 2194%
Blue Shield Exch $52 2194%
Blue Shield Comm - All Other Plans $58 2447%
Carelon - All Plans $58 2447%
Corvel - All Plans $59 2489%
Aetna $60 2532%
Coventry/First Health - All Plans $60 2532%
Galaxy Health - All Plans $60 2532%
Healthnet Comm - All Other Plans $60 2532%
Hmn - All Plans $60 2532%
Integrated Hp - All Other Plans $60 2532%
Interplan - All Plans $60 2532%
Multiplan - All Other Plans $60 2532%
Superior Ca Ppo - All Plans $60 2532%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 N Nagle Street, Alturas, CA 96101
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals