CMS Price Transparency Data

Blood test, hemoglobin

Facility: Franklin General Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $30
Cash Discount Price: $32
vs. Medicare Baseline: 12.66x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Franklin General Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 12.66x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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: $32 (1350%)

Insurance Median: $30 (1266%)

Cash: $32 (1350% of Medicare)

Ins. Median: $30 (1266% 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 1266% of the Medicare baseline (a markup of 1166%). 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
Medical Associates Mcare	$14 - $239	591%
Mount Carmel Hp-All Plans	$14 - $239	591%
Tricare	$14 - $239	591%
Ambetter / Centene	$15 - $382	633%
American Hp Iowa - All Plans	$15 - $251	633%
Amerigroup Mcaid - All Other Plans	$15	633%
Amerigroup Mcare	$15 - $241	633%
Molina Mcaid - All Other Plans	$15	633%
Molina Mcare	$15 - $248	633%
UnitedHealthcare	$15 - $30	633%
Wellmark Mcr Adv	$15	633%
Centivo - All Plans	$22 - $358	928%
Medical Ass Hosp Employer Group	$22	928%
Oscar - All Plans	$22 - $358	928%
Midlands Choice-All Plans	$25	1055%
Medical Associates Hp-All Other Plans	$31	1308%
Preferred Health Choices-All Plans	$31	1308%
Splashlight Llc-All Plans	$31	1308%
Aetna	$33 - $34	1392%
Wellmark Hmo	$33	1392%
Multiplan-All Plans	$34	1435%
Wellmark Ppo - All Other Plans	$36	1519%

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 $32.
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 Franklin General 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.