CMS Price Transparency Data

Blood test, hemoglobin

Facility: Boone County Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $15
Cash Discount Price: $16
vs. Medicare Baseline: 6.33x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Boone County Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 6.33x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$16

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $16 (675%)

Insurance Median: $15 (633%)

Cash: $16 (675% of Medicare)

Ins. Median: $15 (633% 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 633% of the Medicare baseline (a markup of 533%). 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	$2 - $29	84%
Choice Care Mcr Adv - All Plans	$2 - $15	84%
Humana	$2 - $33	84%
Iowa Total Care Mcaid - All Plans	$2 - $17	84%
Medicaid / KanCare	$2 - $17	84%
Meridian Mcaid - All Plans	$2 - $17	84%
Tricare	$2	84%
UnitedHealthcare	$2 - $22	84%
Healthsmart Accell Network	$3 - $26	127%
Healthsmart Ppo - All Other Plans	$3 - $29	127%
Medical Associates Hp-All Plans	$3 - $28	127%
Health Alliance-All Plans	$4 - $33	169%
Midlands Choice-All Plans	$4 - $34	169%
Mutually Preferred-All Plans	$4 - $35	169%
Amerigroup Mcr Adv - All Other Plans	$15	633%
Iowa Hlth Adv - All Plans	$15	633%
Mt Carmel Hp - All Plans	$15	633%
Wellmark Hmo	$26	1097%
Wellmark Ppo - All Other Plans	$29	1224%

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 $16.
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 Boone County 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.