CMS Price Transparency Data

Blood test, hemoglobin

Facility: Lost Rivers Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $20
Cash Discount Price: $25
vs. Medicare Baseline: 8.44x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Lost Rivers Medical Center is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 8.44x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $25 (1055%)

Insurance Median: $20 (844%)

Cash: $25 (1055% of Medicare)

Ins. Median: $20 (844% 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 844% of the Medicare baseline (a markup of 744%). 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
Provider Network Of America-All Plans	$4	169%
Select Health Brightpath-All Other Plans	$18	759%
Tricare	$18	759%
Ihcn Brightpath-All Other Plans	$19	802%
Va Pccc-All Plans	$19	802%
Blue Cross Blue Shield	$20 - $31	844%
Humana	$20	844%
Ihcn Brightpath Mcr Adv	$20	844%
Molina Mcr Adv-All Plans	$20	844%
Pacificsource Mcr Adv	$20	844%
Regence/Brightpth Slhp Mcr	$20	844%
Select Health Mcr Adv	$20	844%
Aetna	$21 - $29	886%
Prime Hlth Mcr Adv	$21	886%
Cigna	$29	1224%
First Choice-All Plans	$29	1224%
Pacificsource Navigator-All Other Plans	$29	1224%
UnitedHealthcare	$29	1224%
Altius Health Plan-All Plans	$30	1266%

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 $25.
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 Lost Rivers Medical Center 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.