CMS Price Transparency Data

Blood test, hemoglobin

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $33
Cash Discount Price: $39
vs. Medicare Baseline: 13.92x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Northwestern Medicine Central Dupage Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 13.92x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$39

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: $39 (1646%)

Insurance Median: $33 (1392%)

Cash: $39 (1646% 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.

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	$3 - $94	127%
Countycare Il Cook Co [1607]	$3 - $6	127%
Medicaid / KanCare	$3 - $6	127%
Aetna	$7 - $33	295%
Carelon Behavioral Health [159]	$23 - $47	970%
Health'S Finest Network [126]	$23 - $86	970%
Multiplan/Phcs [142]	$26 - $94	1097%
Dreyer Med Ipa Advocate [1409]	$28 - $56	1181%
Humana	$28 - $94	1181%
Magellan Behavioral Hlth [136]	$28 - $56	1181%
Healthlink [125]	$29 - $59	1224%
Choicecare [177]	$35 - $72	1477%
First Health Plan [6034]	$35 - $72	1477%
Cigna	$37 - $75	1561%
Compsych [112]	$37 - $75	1561%
UnitedHealthcare	$46 - $94	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 $39.
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 Northwestern Medicine Central Dupage 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.