CMS Price Transparency Data

Blood test, hemoglobin

Facility: Valley Children's Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $53
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 22.36x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Valley Children's Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 22.36x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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%)
Insurance Median: $53 (2236%)
Ins. Median: $53 (2236% 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 2236% of the Medicare baseline (a markup of 2136%). 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
Allcare Ipa $3 - $48 127%
Central California Alliance For Health $5 211%
Central Valley Medical Providers Ipa $5 - $48 211%
Community Care Ipa $5 211%
Dignity Ipa_Formerly Img $5 211%
Kaiser $5 - $63 211%
La Salle Ipa $5 211%
Sante Ipa $5 211%
Sequoia Health Ipa $5 211%
United Physicians Network Ipa $5 - $48 211%
Univseral Healthcare Ipa $5 211%
Adventist $6 253%
Blue Cross Blue Shield $6 - $24 253%
Cencal Health $7 295%
Kern Family Health Care $7 295%
Health Net $34 - $64 1435%
Dignity Health Central Coast $48 2025%
Community Health $53 2236%
Stanislaus Partners In Health $53 2236%
Physicians Choice Medical Group $54 2278%
Health Plan Of San Joaquin $58 2447%
Fowler Packing $60 2532%
Dignity (Formerly Managed Care Systems) $61 2574%
Kern Legacy $63 2658%
Aetna $65 2743%
Blue Shield $65 - $74 2743%
UnitedHealthcare $65 - $98 2743%
First Health Formerly Coventry $72 3038%
Bakersfield Family Medical Group $73 3080%
Network By Design $75 3165%
Community Care Health Plan $78 3291%
Health Smart $78 3291%
Key Medical Ipa $78 3291%
Sutter Health $82 3460%
Multiplan $93 3924%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens