CMS Price Transparency Data

Blood test, hemoglobin

Facility: Northside Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $47
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 19.83x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Northside Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 19.83x the Medicare baseline. Located in 1000 Johnson Ferry Road, Ne, Atlanta, GA.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $56 (2363%)
Insurance Median: $47 (1983%)
Cash: $56 (2363% of Medicare)
Ins. Median: $47 (1983% 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 1983% of the Medicare baseline (a markup of 1883%). 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 - $15 84%
Bccp $2 84%
Blue Cross Blue Shield $2 - $52 84%
Caresource $2 - $28 84%
Cbww $2 84%
Champus Va $2 84%
Clear Springs Eon Health $2 84%
Clover Health $2 84%
Coventry $2 - $51 84%
Fairly Group $2 84%
Humana $2 84%
Kaiser $2 - $65 84%
Medicaid / KanCare $2 - $3 84%
Medicare (plans) $2 - $3 84%
Pruitt Health Premier $2 84%
Tricare $2 84%
UnitedHealthcare $2 - $12 84%
Va Ccn $2 84%
Wellcare $2 84%
Ambetter / Centene $3 - $15 127%
Amerigroup $3 - $12 127%
Us Dept Of Labor Wc $3 127%
Corvel Workers Comp $4 169%
Employers Choice Network $4 169%
Georgia Workers Compensation $4 169%
Oscar $4 169%
Streamline Imaging $4 169%
Cigna $12 - $47 506%
Northside Health Network $22 928%
Georgia Reproductive Specialists $29 - $30 1224%
Medlien Healthcare Services $29 - $30 1224%
Med Care Solutions $33 - $34 1392%
Health One Alliance_Ppo $40 - $41 1688%
Quick Trip $40 - $41 1688%
Novanet_Ppo $51 - $52 2152%
Phcs $55 - $56 2321%
Beech Steet $62 - $64 2616%
Multiplan $62 - $64 2616%
Multiplan Workers Comp $62 - $64 2616%
Careiq $73 - $75 3080%
Dekalb_Department Of Health $73 - $75 3080%
Fifa $73 - $75 3080%
Institutional Marietta Surgery Center $73 - $75 3080%
Institutional Veterans Evaluation Services $73 - $75 3080%
Rabun County Boc $73 - $75 3080%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Johnson Ferry Road, Ne, Atlanta, GA 30342
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals