CMS Price Transparency Data

Blood test, hemoglobin

Facility: Hamilton Memorial Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $9
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 3.80x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Hamilton Memorial Hospital is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 3.80x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $15 (633%)
Insurance Median: $9 (380%)
Cash: $15 (633% of Medicare)
Ins. Median: $9 (380% 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 380% of the Medicare baseline (a markup of 280%). 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 - $28 84%
Blue Cross Blue Shield $2 - $29 84%
Health Alliance $2 - $25 84%
Humana $2 - $13 84%
Medicaid / KanCare $2 - $13 84%
Medicare (plans) $2 - $13 84%
UnitedHealthcare $2 - $23 84%
Wellcare $2 - $13 84%
Alliance Coal $4 - $22 169%
Healthscope $4 - $22 169%
Wellfirst (Ssmhic) $4 - $22 169%
Cigna $5 - $25 211%
Healthlink $5 - $28 211%
Hfn, Inc $5 - $28 211%
Hope Trust $5 - $24 211%
Multiplan $5 - $27 211%
Siho $5 - $28 211%
Three Rivers Provider $5 - $28 211%
Healthsmart $6 - $30 253%
Stratose $6 - $30 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals