Blood test, hemoglobin
Facility: Susan B Allen Memorial Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $554
- Cash Discount Price: $18
- vs. Medicare Baseline: 233.76x 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 23376% of the Medicare baseline (a markup of 23276%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 14768% |
| Providrs Care | $757 | 31941% |
Consumer Guidance & Cost Commentary
For this blood test for hemoglobin at Susan B Allen Memorial Hospital in El Dorado, KS, the cash price is $18.00, which is significantly lower than the facility's negotiated rates of $554.00 with UnitedHealthcare and Providrs Care. While insurance contracts often result in higher out-of-pocket costs due to administrative fees and claim processing, paying cash upfront can be the most economical option for patients with high-deductible plans or those without coverage. To secure the lowest possible price, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront incentives can bypass the costly insurance billing cycle and reduce the total amount owed.
It is important to note that this facility's cash rate of $18.00 is substantially lower than the state of Kansas average for this service, making it a cost-effective choice for self-pay patients. However, if you have insurance, be aware that the negotiated rate of $554.00 may exceed your deductible, meaning you could end up paying more than the cash price even if the insurance covers part of the bill. If you receive a large bill after using insurance, do not pay immediately; instead, request a full itemized audit to verify that no unbundled codes or services not rendered are included, and dispute any balance billing that violates the No Surprises Act protections.