CMS Price Transparency Data

Blood test, hemoglobin

Facility: Woodlawn Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $13
Cash Discount Price: $44
vs. Medicare Baseline: 5.49x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Woodlawn Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 5.49x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $44 (1857%)

Insurance Median: $13 (549%)

Cash: $44 (1857% of Medicare)

Ins. Median: $13 (549% 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 549% of the Medicare baseline (a markup of 449%). 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	$1 - $44	42%
Partners Direct Health-All Plans	$1	42%
UnitedHealthcare	$1 - $44	42%
Caresource Mcaid Hww	$2	84%
Mdwise Excel Hhw & Hcc	$2	84%
Mhs Mcaid Hcc	$2	84%
Mhs Mcaid Hhw	$2	84%
Aetna	$13 - $55	549%
Caresource Mcaid Hip	$13	549%
Caresource Mcr Adv	$13	549%
Humana	$13 - $45	549%
Mdwise Mcaid Excel Hip	$13	549%
Mhs Exch Mrktplce-All Other Plans	$13	549%
Mhs Mcaid Hip	$13	549%
Mhs Mcr Adv	$13	549%
Ambetter / Centene	$17	717%
Caresource Exch - All Other Plans	$17	717%
Cigna	$42 - $49	1772%
Parkview Health Plans-All Plans	$44	1857%
Encore Comm-All Plans	$49	2068%
Sagamore All Other Grps - All Other Plans	$49	2068%
Phcs/Multiplan-All Plans	$54	2278%
Community Health Alliance-All Plans	$55	2321%

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 $44.
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 Woodlawn 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.