Blood test, hemoglobin
Facility: Dukes Memorial Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $15
- Cash Discount Price: $35
- vs. Medicare Baseline: 6.33x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 633% of the Medicare baseline (a markup of 533%). 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.
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 | $2 - $22 | 84% |
| Caresource | $2 | 84% |
| Department Of Veterans Affairs | $2 - $13 | 84% |
| Humana | $2 - $14 | 84% |
| Managed Health Services | $2 - $28 | 84% |
| Medicaid / KanCare | $2 | 84% |
| Mhs | $2 | 84% |
| Tricare | $2 - $13 | 84% |
| UnitedHealthcare | $2 - $34 | 84% |
| Veterans Eval Services | $2 | 84% |
| Aetna | $3 - $33 | 127% |
| In Dept Of Correction | $3 - $15 | 127% |
| Iu Health Plan | $3 - $14 | 127% |
| Medicare (plans) | $3 - $14 | 127% |
| Miami County Sheriffs Department | $3 - $15 | 127% |
| Node Devoted Health Mcr Adv | $3 - $14 | 127% |
| Node Pphp Mcr Adv | $3 - $15 | 127% |
| Node Va | $3 - $34 | 127% |
| Us Department Of Labor | $3 | 127% |
| Align Network | $4 - $22 | 169% |
| Lutheran Advanced Network | $4 - $21 | 169% |
| Lutheran Preferred | $4 - $56 | 169% |
| Lutheran Three Rivers Preferred Plus 150 | $4 - $21 | 169% |
| Node Lutheran Preferred Fixed 2 | $4 - $21 | 169% |
| Encore Work Comp In | $5 - $25 | 211% |
| Lutheran Northwest Health Preferred | $5 - $28 | 211% |
| Lutheran Three Rivers Preferred Plus 175 | $5 - $24 | 211% |
| Partners Direct Health Llc | $5 - $27 | 211% |
| Physicians Health Plan | $5 - $33 | 211% |
| Prime Health Services | $5 - $52 | 211% |
| Three Rivers Preferred Plus | $5 - $28 | 211% |
| Work Comp | $5 - $28 | 211% |
| Amish Aid | $6 - $35 | 253% |
| Cigna | $6 - $70 | 253% |
| Encore Kba Epo | $6 - $34 | 253% |
| Encore Ppo | $6 - $35 | 253% |
| Php Freedom | $6 - $32 | 253% |
| Self Pay | $6 - $38 | 253% |
| Three Rivers Preferred | $6 - $32 | 253% |
| Sagamore Health Network | $7 - $39 | 295% |
| Consumer Life | $8 - $43 | 338% |
| Encore Kba Ppo | $8 - $42 | 338% |
| First Health | $10 - $56 | 422% |
| Advantage Health Solutions | $11 - $58 | 464% |
| Encore Health Network | $11 - $57 | 464% |
| Multiplan | $11 - $57 | 464% |
| Encore | $12 - $63 | 506% |