CMS Price Transparency Data

Blood test, hemoglobin

Facility: St Joseph's Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $442
  • Cash Discount Price: $374
  • vs. Medicare Baseline: 186.50x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at St Joseph's Hospital is $442. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $374. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 186.50x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$374

Average discount available for prompt cash payment at this facility.

Insurance Median
$442

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: $374 (15781%)
Insurance Median: $442 (18650%)
Cash: $374 (15781% of Medicare)
Ins. Median: $442 (18650% 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 18650% of the Medicare baseline (a markup of 18550%). 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
Illinois Breast and Cervical Cancer Program $2 84%
Caterpillar, Inc. $5 211%
UnitedHealthcare $5 - $520 211%
Cigna $6 253%
Meridian Health Plan $10 422%
Molina Healthcare $10 - $520 422%
Aetna $104 - $520 4388%
Humana $104 - $520 4388%
Blue Cross Blue Shield $104 - $520 4388%
Clear Spring Health of Illinois $104 - $520 4388%
Sae Hospice $104 - $520 4388%
Amish Community $146 6160%
Naphcare $218 - $1,092 9198%
Celtic Insurance Company $229 - $520 9662%
Claim Doc $260 - $1,300 10970%
Hopetrust $260 - $520 10970%
Wellfirst $333 14051%
First Health $384 16203%
Multiplan/Phcs $442 18650%
Healthlink $442 18650%
Provider Network of America $468 19747%
Healthcare Finest Network (Hfn) $468 19747%
Interplan $520 21941%
Healthscope $520 21941%
Current Health Solutions $520 21941%
Mental Health Network $520 21941%
Health Alliance Medical Plans $520 21941%
Qtc Medical Group of Illinois $520 21941%
Consociate Group $520 21941%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals