Blood test, hemoglobin
Facility: Saint John Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $2
- Cash Discount Price: $2
- vs. Medicare Baseline: 0.84x 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 |
|---|---|---|
| Medicare (plans) | $2 | 84% |
| Medicaid / KanCare | $2 | 84% |
| UnitedHealthcare | $2 - $3 | 84% |
| Tricare | $2 | 84% |
| Kansas Superior Select | $2 | 84% |
| Healthy Blue | $2 | 84% |
| Aetna | $2 - $4 | 84% |
| Midland Care Connection | $2 | 84% |
| Cigna | $2 | 84% |
| Celtic | $2 - $16 | 84% |
| Employer Direct Healthcare | $3 | 127% |
| Well Path | $3 | 127% |
| Corizon | $3 | 127% |
| Centurion | $4 | 169% |
| Naphcare | $4 | 169% |
| Comp Alliance Workers Comp | $5 | 211% |
| Worker Compensation | $5 | 211% |
| Blue Cross Blue Shield | $5 - $10 | 211% |
| Oha Networks | $5 | 211% |
Consumer Guidance & Cost Commentary
For this blood test service at Saint John Hospital in Leavenworth, KS, the cash price is $2.00, which is significantly lower than the facility's negotiated rate of $23.00. While the facility's cash rate is notably lower than the state average of $23.00, patients with high-deductible plans should consider that paying cash upfront might be more cost-effective than using insurance, as the negotiated rate often exceeds the cash price. It is important to note that the facility's cash rate is also lower than the Medicare benchmark of $2.37, which serves as the objective baseline for evaluating pricing markups.
The facility has established contracts with 19 different payers, including Medicare, Medicaid, and major commercial insurers like UnitedHealthcare and Aetna. However, because these negotiated rates can vary significantly by payer and plan, patients should verify their specific allowed amounts before scheduling. Additionally, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance billing cycles.