CMS Price Transparency Data

Blood test, hemoglobin

Facility: HSHS St Elizabeth's Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $36
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 15.19x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at HSHS St Elizabeth's Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 15.19x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $30 (1266%)
Insurance Median: $36 (1519%)
Cash: $30 (1266% of Medicare)
Ins. Median: $36 (1519% 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 1519% of the Medicare baseline (a markup of 1419%). 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 $2 - $41 84%
Blue Cross Blue Shield $2 - $41 84%
Clear Spring Health Of Illinois $2 - $41 84%
Health Alliance Medical Plans $2 - $41 84%
Health Partners $2 - $41 84%
Humana $2 - $41 84%
Illinois Breast And Cervical Cancer Program $2 84%
Molina Healthcare $2 - $41 84%
Sae Hospice $2 - $41 84%
UnitedHealthcare $2 - $41 84%
Celtic Insurance Company $5 - $41 211%
Meridian Health Plan $5 211%
Naphcare $5 - $41 211%
Claim Doc $6 - $41 253%
Hopetrust $6 - $41 253%
Amish Community $11 464%
Wellfirst $26 1097%
First Health $30 1266%
Cigna $32 - $41 1350%
Caterpillar, Inc. $33 1392%
Healthlink $33 - $41 1392%
Consociate Group $36 1519%
Choicecare $37 1561%
Healthcare Finest Network (Hfn) $37 1561%
Multiplan/Phcs $37 1561%
Provider Network Of America $37 1561%
City Of Springfield $41 1730%
Current Health Solutions $41 1730%
Healthscope $41 1730%
Interplan $41 1730%
Live360 $41 1730%
Wexford $41 1730%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals