CMS Price Transparency Data

Blood test, hemoglobin

Facility: St Francis Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $16
  • Cash Discount Price: $691
  • vs. Medicare Baseline: 6.75x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at St Francis Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $691. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 6.75x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$691

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $691 (29156%)
Insurance Median: $16 (675%)
Cash: $691 (29156% of Medicare)
Ins. Median: $16 (675% 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 675% of the Medicare baseline (a markup of 575%). 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
Blue Cross Blue Shield $2 - $32 84%
Blue Shield - De (Highmark) Medciare Advantage $2 84%
Cigna $2 - $50 84%
Highmark Health Options Dual Plan $2 84%
Medicare (plans) $2 84%
Pace-Trinity Health $2 84%
Saint Francis Life $2 84%
Aetna $3 - $53 127%
Coventry $3 127%
Delaware First Health $5 211%
Blue Benefit Administrators Of Massachusetts $16 675%
Blue Care Network $16 675%
Blue Distinction Transplant $16 675%
Blue Shield - Ca $16 675%
Blue Shield - Id (Regence) $16 675%
Blue Shield - Ny Highmark Northeastern $16 675%
Blue Shield - Ny Highmark Western $16 675%
Blue Shield - Pa (Highmark) $16 675%
Blue Shield - Wa (Regence) $16 675%
Medicaid / KanCare $28 1181%
Amerihealth $32 1350%
Meritain $53 2236%
Trustmark Small Business Benefits $53 2236%
Devon Health Services $77 3249%
Galaxy Health Network $77 3249%
Multiplan $77 3249%
Prime Health Services $77 3249%
Three Rivers Provider Network $77 3249%
Wc Corvel $77 3249%
Geha $78 3291%
UnitedHealthcare $78 3291%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7Th and Clayton Sts, Wilmington, DE 19805
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals