Blood test, hemoglobin
Facility: Providence Medical Center
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 |
|---|---|---|
| Celtic | $2 - $4 | 84% |
| Tricare | $2 | 84% |
| Kansas Superior Select | $2 | 84% |
| Healthy Blue | $2 | 84% |
| Aetna | $2 - $4 | 84% |
| Medicaid / KanCare | $2 | 84% |
| Midland Care Connection | $2 | 84% |
| Blue Cross Blue Shield | $2 - $6 | 84% |
| UnitedHealthcare | $2 - $4 | 84% |
| Cigna | $2 | 84% |
| Medicare (plans) | $2 | 84% |
| Employer Direct Healthcare | $3 | 127% |
| Well Path Prison | $3 | 127% |
| Corizon | $3 | 127% |
| Naphcare | $4 | 169% |
| Centurion | $4 | 169% |
| Worker Compensation | $5 | 211% |
| Oha Networks | $5 | 211% |
| Comp Alliance - Fka Compresults Worker Compensation | $5 | 211% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Providence Medical Center in Kansas City, KS, the cash median price is $2.00, which is significantly lower than the Medicare benchmark of $2.37. While many commercial payers negotiate rates that often exceed cash prices due to administrative costs and claim processing fees, patients with high-deductible plans may find that paying the cash rate upfront is the most cost-effective option. It is important to note that the facility offers a voluntary non-profit structure, and patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible rate, as waiting until after services are rendered often results in higher charges.
The facility's pricing is evaluated against a baseline of 0.8 times the Medicare amount, indicating a rate that is 20% below the federal benchmark. Although the data does not provide specific state or county average comparisons for this specific CPT code, the significant difference between the cash price and the Medicare amount highlights the potential for substantial savings when paying directly. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to verify the exact allowed amount with the insurance carrier before proceeding, as some ancillary services or specific plan structures may still result in unexpected costs if not carefully reviewed.