CMS Price Transparency Data

Blood test, hemoglobin

Facility: Fishermen's Community Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $60
Cash Discount Price: $59
vs. Medicare Baseline: 25.32x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Fishermen's Community Hospital is $60. 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 25.32x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

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: $60 (2532%)

Cash: $59 (2489% of Medicare)

Ins. Median: $60 (2532% 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 2532% of the Medicare baseline (a markup of 2432%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$3 - $74	127%
Amerigroup	$3	127%
Medicaid / KanCare	$3	127%
Sunshine State	$3	127%
UnitedHealthcare	$3 - $96	127%
Vista	$3	127%
Wellcare	$3	127%
Blue Cross Blue Shield	$14 - $96	591%
Leon Medical	$18 - $20	759%
Medica Health Plan	$18 - $20	759%
Medicare (plans)	$18 - $27	759%
Avmed	$19 - $79	802%
Humana	$19 - $22	802%
Cigna	$20 - $77	844%
Non Contracted	$31 - $35	1308%
International	$55 - $62	2321%
Amerihealth	$63 - $72	2658%
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

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $59.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85018.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fishermen's Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85018.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.