CMS Price Transparency Data

Blood test, hemoglobin

Facility: Major Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $29
Cash Discount Price: $14
vs. Medicare Baseline: 12.24x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Major Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 12.24x the Medicare baseline. Located in 2451 Intelliplex Dr, Shelbyville, IN.

Cash / Self-Pay

$14

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $14 (591%)

Insurance Median: $29 (1224%)

Cash: $14 (591% of Medicare)

Ins. Median: $29 (1224% 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 1224% of the Medicare baseline (a markup of 1124%). 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
UnitedHealthcare	$1 - $29	42%
Blue Cross Blue Shield	$2 - $22	84%
Caresource Mrktplce -All Plans	$4	169%
Ambetter / Centene	$5	211%
Sho Direct-All Plans	$25	1055%
Phcs - All Plans	$34	1435%
Aetna	$38	1603%
Siho-All Plans	$39	1646%
Humana	$41	1730%
First Health - All Plans	$42	1772%
Cigna	$45	1899%

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 $14.
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 Major 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.