Blood test, hemoglobin
Facility: Wesley Medical Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $5
- Cash Discount Price: $270
- vs. Medicare Baseline: 2.11x 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 211% of the Medicare baseline (a markup of 111%). 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 |
|---|---|---|
| Medicaid / KanCare | $2 | 84% |
| UnitedHealthcare | $2 | 84% |
| Humana | $2 | 84% |
| United | $2 - $122 | 84% |
| Coventry Health Care | $2 | 84% |
| Amerigroup | $2 | 84% |
| Ambetter / Centene | $2 - $49 | 84% |
| Triwest Health Alliance | $2 | 84% |
| Aetna | $2 - $96 | 84% |
| Devoted Health | $2 | 84% |
| Correct Care Solutions | $4 | 169% |
| First Health | $5 - $124 | 211% |
| Multiplan | $5 - $243 | 211% |
| Blue Cross Blue Shield | $7 | 295% |
| Health Partners Of Kansas | $47 - $135 | 1983% |
| Wppa | $47 | 1983% |
| Medical Associates Health Plan | $51 | 2152% |
| Preferred Health Choices | $51 | 2152% |
| Spirit Aerosystems | $86 | 3629% |
| Triwest Healthcare Alliance | $176 | 7426% |
| Usa Managed Care | $230 | 9705% |
Consumer Guidance & Cost Commentary
For the blood test, hemoglobin service (CPT 85018) at Wesley Medical Center in Wichita, KS, the cash median price is $270.00, which matches the facility's gross charge. This rate is significantly higher than the state average, reflecting a markup of 210% compared to Medicare's benchmark rate of $2.37. While commercial insurance contracts often result in negotiated rates that are higher than cash prices due to administrative overhead and contract dynamics, patients with high-deductible plans may find paying cash directly more cost-effective if the insurance allowed amount exceeds the cash price. It is important to verify your specific plan's negotiated rate before scheduling, as in-network rates can vary widely between carriers.
Patients should be aware that hospitals frequently offer prompt-pay discounts for self-pay patients who settle their bill upfront, which can reduce the final cost by 20% to 50%. Since the cash price here is already set at the gross charge, requesting a self-pay or prompt-pay discount at the time of registration is the most effective way to lower the amount owed. Additionally, if you have insurance, ensure you are not inadvertently signing away your rights to dispute out-of-network balance billing, as federal protections like the No Surprises Act may prevent certain surprise charges even at in-network facilities. Always demand a full, itemized bill before making any payment to ensure all charges are accurate and to identify any potential errors or unbundled codes that could be corrected.