CMS Price Transparency Data

Blood test, hemoglobin

Facility: South Miami Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $32
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 13.50x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at South Miami Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 13.50x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $47 (1983%)
Insurance Median: $32 (1350%)
Cash: $47 (1983% of Medicare)
Ins. Median: $32 (1350% 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 1350% of the Medicare baseline (a markup of 1250%). 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
Aetna $2 - $77 84%
Amerihealth $2 - $43 84%
Avmed $2 - $48 84%
Blue Cross Blue Shield $2 - $62 84%
Cigna $2 - $77 84%
Medicare (plans) $2 - $3 84%
Non Contracted $2 - $35 84%
UnitedHealthcare $2 - $96 84%
Amerigroup $3 127%
Humana $3 127%
International $3 - $62 127%
Leon Medical $3 127%
Medica Health Plan $3 127%
Medicaid / KanCare $3 127%
Sunshine State $3 127%
Vista $3 127%
Wellcare $3 127%
Affordable $4 - $82 169%
Dimension Health Plan $4 - $86 169%
Phcs $4 - $86 169%
Quality Health $4 - $86 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 Sw 73Rd St, Miami, FL 33143
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals