CMS Price Transparency Data

Blood test, hemoglobin

Facility: Madison County Health Care System

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $33
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 13.92x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Madison County Health Care System is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 13.92x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $38 (1603%)
Insurance Median: $33 (1392%)
Cash: $38 (1603% of Medicare)
Ins. Median: $33 (1392% 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 1392% of the Medicare baseline (a markup of 1292%). 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 $15 - $38 633%
Medical Associates Hp - All Plans $15 - $25 633%
Medigold-All Plans $15 - $25 633%
Tricare $15 - $25 633%
UnitedHealthcare $15 - $53 633%
American Hp Mcr Adv-All Plans $16 - $27 675%
Iowa Total Care Mcaid-All Plans $16 - $28 675%
Amerigroup Mcaid-All Plans $17 - $29 717%
Molina Mcaid/Chip -All Plans $17 - $29 717%
Madison County Sheriff-All Plans $18 - $30 759%
Oscar - All Plans $23 - $38 970%
Corvel Wc-All Plans $32 - $53 1350%
Blue Cross Blue Shield $33 - $36 1392%
Choicecare-All Plans $33 - $56 1392%
First Choice-All Plans $33 - $56 1392%
First Health-All Plans $33 - $56 1392%
Integrated Hp-All Plans $33 - $56 1392%
Mutual Of Omaha-All Plans $33 - $56 1392%
Plaines Health-All Plans $33 - $56 1392%
Preferred Hlth Ntwork-All Plans $33 - $56 1392%
Principal Healthcare-All Plans $33 - $56 1392%
Usa Managed Care-All Plans $33 - $56 1392%
Medimore Employee Hp - All Plans $34 - $58 1435%
Midlands Choice - All Plans $34 - $58 1435%
Benefit Admin Of America-All Plans $35 - $59 1477%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals