CMS Price Transparency Data

Blood test, hemoglobin

Facility: West Kendall Baptist Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $42
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 17.72x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at West Kendall Baptist Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 17.72x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $59 (2489%)
Insurance Median: $42 (1772%)
Cash: $59 (2489% of Medicare)
Ins. Median: $42 (1772% 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 1772% of the Medicare baseline (a markup of 1672%). 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 - $62 84%
Medicare (plans) $2 - $3 84%
Aetna $3 - $77 127%
Amerigroup $3 127%
Avmed $3 - $47 127%
Cigna $3 - $77 127%
Humana $3 127%
Leon Medical $3 127%
Medica Health Plan $3 127%
Medicaid / KanCare $3 127%
Sunshine State $3 127%
UnitedHealthcare $3 - $96 127%
Vista $3 127%
Wellcare $3 127%
Non Contracted $31 - $35 1308%
Amerihealth $38 - $43 1603%
International $55 - $62 2321%
Dimension Health Plan $63 - $86 2658%
Affordable $76 - $86 3207%
Phcs $76 - $86 3207%
Quality Health $76 - $86 3207%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals