Blood test, hemoglobin
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $29
- Cash Discount Price: $21
- vs. Medicare Baseline: 12.24x 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 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.
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 |
|---|---|---|
| Healthcare Highways [2210] | $29 | 1224% |
| Blue Cross Blue Shield | $29 | 1224% |
| Oncology Patient Assistance Programs [2295] | $29 | 1224% |
| Lucent Health [6000] | $29 | 1224% |
| Web Tpa [2115] | $29 | 1224% |
| Black Lung [6055] | $29 | 1224% |
| Aetna | $29 | 1224% |
| Hooray Health [8000] | $29 | 1224% |
| Department Of Corrections [1340] | $36 | 1519% |
| Healthpartners [1500] | $41 | 1730% |
| Cigna | $41 | 1730% |
| National Association Of Letter Carriers [1695] | $41 | 1730% |
| American Postal Workers Union [1070] | $41 | 1730% |
| Humana | $42 | 1772% |
| Administrative Concepts [1005] | $55 | 2321% |
| American Healthcare [1055] | $55 | 2321% |
| First Health [1375] | $55 | 2321% |
| Multiplan [1680] | $55 | 2321% |
| Coventry Healthcare [1320] | $59 | 2489% |
| Ks Disability Determination [6090] | $71 | 2996% |
Consumer Guidance & Cost Commentary
For this blood test procedure at the University of Kansas Health System - St Francis Campus, the negotiated rate is $29.00, which is significantly lower than the facility's gross charge of $71.00. While the cash price is listed at $21.00, patients with high-deductible plans should consider that paying out-of-pocket might save money if their insurance negotiated rate exceeds the cash price. It is important to verify your specific plan's allowed amount before scheduling, as some in-network contracts can result in higher costs than direct cash payment. Additionally, patients should explicitly 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 claims processing.
This service is benchmarked against Medicare, which sets a fixed reimbursement rate of $2.37 for this code. The facility's gross charge represents a substantial markup compared to the federal baseline, illustrating why comparing rates to the Medicare amount rather than the hospital's list price is essential for understanding true value. The data indicates that the state and county averages are not explicitly provided in this specific record, so the comparison is limited to the facility's internal rates and the federal Medicare standard. To avoid unexpected costs, patients should request an itemized bill to ensure no services were double-billed or unbundled, and they should dispute any balance billing immediately if they receive a bill for the difference between the provider's full charge and their insurance payment, as federal protections may apply.