CMS Price Transparency Data

Blood test, hemoglobin

Facility: Palos Community Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $39
Cash Discount Price: $36
vs. Medicare Baseline: 16.46x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Palos Community Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 16.46x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $36 (1519%)

Insurance Median: $39 (1646%)

Cash: $36 (1519% of Medicare)

Ins. Median: $39 (1646% 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 1646% of the Medicare baseline (a markup of 1546%). 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
Blue Cross Blue Shield	$7 - $54	295%
Aetna	$10 - $54	422%
Carelon Behavioral Health [159]	$23 - $27	970%
Healthlink [125]	$23 - $54	970%
Magellan Behavioral Hlth [136]	$28 - $32	1181%
Multiplan/Phcs [142]	$32 - $54	1350%
Compsych [112]	$34 - $40	1435%
First Health Plan [6034]	$34 - $40	1435%
Beechstreet [176]	$37 - $43	1561%
Cigna	$37 - $54	1561%
Health'S Finest Network [126]	$39 - $46	1646%
Galaxy Health Network [220]	$46 - $54	1941%
Global Excel [1712]	$46 - $54	1941%
Health Alliance [181]	$46 - $54	1941%
UnitedHealthcare	$46 - $54	1941%

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 $36.
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 Palos Community 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.