Blood test, hemoglobin
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $4
- Cash Discount Price: $26
- vs. Medicare Baseline: 1.69x 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.
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 |
|---|---|---|
| Humana | $2 | 84% |
| Halo Hcr Inc Hospice Contracted [320432] | $2 | 84% |
| Aetna | $2 - $34 | 84% |
| Tricare | $2 | 84% |
| Medicaid / KanCare | $2 - $4 | 84% |
| Dept Of Veteran Affairs Contracted [320106] | $2 | 84% |
| Medicare (plans) | $2 | 84% |
| Kindful Hospice Contracted [320434] | $2 | 84% |
| Pace Of The Ozarks Contracted [320518] | $2 | 84% |
| UnitedHealthcare | $2 - $27 | 84% |
| Kindful Hospice [20434] | $2 | 84% |
| Mercy Hospice Okc [20252] | $2 | 84% |
| Halo Hcr Inc Hospice [20432] | $2 | 84% |
| Blue Cross Blue Shield | $2 - $12 | 84% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $2 | 84% |
| Medica Contracted [320239] | $2 | 84% |
| Elara Caring Aspire Hospice [20433] | $2 | 84% |
| Cross Timbers Hospice [20098] | $2 | 84% |
| Health Choice Contracted [320166] | $3 | 127% |
| Ambetter / Centene | $4 | 169% |
| Providrs Care Network Contracted [320484] | $4 | 169% |
| Home State Health Plan Contracted [320187] | $4 | 169% |
| Cigna | $13 | 549% |
| United Medical Resources Contracted [320454] | $27 | 1139% |
| Aither Health Contracted [320449] | $32 | 1350% |
| Mercy Benefit Admin Contracted [320251] | $32 | 1350% |
| Edison Health Solutions Contracted [320502] | $32 | 1350% |
| American Healthcare Alliance Contracted [320020] | $32 | 1350% |
| Imagine 360 Contracted [320494] | $32 | 1350% |
| Reflect Health Contracted [320492] | $32 | 1350% |
| Yuzu Health Contracted [320521] | $32 | 1350% |
| Healthlink Contracted [320179] | $32 | 1350% |
| Auxiant Contracted [320462] | $32 | 1350% |
| Ebms Contracted [320493] | $32 | 1350% |
| Workers Comp [20426] | $32 | 1350% |
| First Health Contracted [320128] | $34 | 1435% |
Consumer Guidance & Cost Commentary
For this blood test service at Mercy Hospital Pittsburg, Inc., the facility's cash price of $26.00 is notably lower than the state average for this procedure, which is $27.00. While the facility's median negotiated rate is $4.00, this figure represents the maximum amount insurers are contractually allowed to pay, not the actual cost to the patient. Patients with high-deductible plans may find that paying the cash price of $26.00 upfront is more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price due to administrative overhead. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill.
The facility's pricing structure is benchmarked against Medicare, with the Medicare amount for this code set at $2.37. The facility's cash rate of $26.00 is approximately 1.7 times the Medicare amount, which falls within the typical range for commercial pricing where rates often average 200% to 300% of Medicare. Because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement before paying to ensure no charges are duplicated or unbundled. If a balance bill arises from an out-of-network ancillary service, patients should dispute the amount immediately and request a No Surprises Act audit rather than paying the full amount out of fear of credit damage.