Blood test, hemoglobin
Facility: Mcpherson Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $19
- Cash Discount Price: $19
- vs. Medicare Baseline: 8.02x 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 802% of the Medicare baseline (a markup of 702%). 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 | $2 - $74 | 84% |
| Tricare | $2 | 84% |
| Blue Cross Blue Shield | $2 | 84% |
| Healthy Blue Mcr Adv | $2 | 84% |
| Humana | $2 | 84% |
| Va Ccn - All Plans | $2 | 84% |
| Wellcare Mcr Adv - All Plans | $2 | 84% |
| Ambetter / Centene | $3 | 127% |
| Wppa - All Plans | $13 - $52 | 549% |
| Central Plains - All Plans | $14 - $56 | 591% |
| Medical Associates - All Plans | $14 - $56 | 591% |
| Christian Health Aid - All Plans | $14 - $59 | 591% |
| Aetna | $15 - $74 | 633% |
| Multiplan - All Plans | $16 - $67 | 675% |
| First Health - All Plans | $17 - $70 | 717% |
| Cigna | $17 - $70 | 717% |
| Health Partners - All Plans | $17 - $70 | 717% |
| Health Blue Mcaid - All Other Plans | $18 - $75 | 759% |
| Medicaid / KanCare | $18 - $74 | 759% |
Consumer Guidance & Cost Commentary
For the blood test, hemoglobin (CPT 85018) at McPherson Hospital in McPherson, Kansas, the facility's cash median rate is $19.00, which is $8.00 higher than the Medicare benchmark of $2.37. While commercial negotiated rates vary significantly by payer—ranging from $2.00 for UnitedHealthcare and Tricare to $75.00 for Health Blue Mcaid—these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find paying the cash rate directly more cost-effective than relying on insurance, as the negotiated allowed amounts for many plans sit well above the $19.00 cash price. It is important to note that while the facility is a voluntary non-profit acute care hospital, the specific negotiated rates depend on your individual plan's contract with the payer, and some plans may have lower ceilings than others.
Before scheduling, we strongly recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. This discount bypasses the costly insurance claims processing cycle, saving the facility administrative fees that are often baked into the higher negotiated rates. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, you can be confident that the final charge will not include unexpected fees for emergency or ancillary services. If you receive an itemized bill, review it carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain