Blood test, hemoglobin
Facility: Overland Park Reg Med Ctr
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $34
- Cash Discount Price: $157
- vs. Medicare Baseline: 14.35x 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 1435% of the Medicare baseline (a markup of 1335%). 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 |
|---|---|---|
| Cigna | $1 - $2 | 42% |
| Coventry | $2 - $69 | 84% |
| Blue Cross Blue Shield | $2 - $74 | 84% |
| Wellcare | $2 | 84% |
| Triwest Health Alliance | $2 | 84% |
| Humana | $2 - $6 | 84% |
| United | $2 - $78 | 84% |
| Amerigroup | $2 | 84% |
| Home State Health Plan | $2 | 84% |
| Aetna | $2 - $88 | 84% |
| Medicaid / KanCare | $2 | 84% |
| Healthyblue | $2 | 84% |
| Celtic | $2 | 84% |
| Unicare | $2 | 84% |
| Devoted Health | $2 | 84% |
| Pyramid Life | $3 | 127% |
| Multiplan | $4 - $128 | 169% |
| Oscar | $4 | 169% |
| Oha Network | $5 - $86 | 211% |
| Corvel Corporation | $5 - $112 | 211% |
| Nhc Advantage | $26 - $33 | 1097% |
| Ambetter / Centene | $26 - $32 | 1097% |
| Wppa Providrs Care Network | $27 - $35 | 1139% |
| Universal Healthcare | $48 - $60 | 2025% |
| Coventry Kc Mo | $56 - $71 | 2363% |
| College Park Family Care Center | $59 - $74 | 2489% |
| Cco, Inc. | $103 - $130 | 4346% |
| Focus Healthcare Mgmt, Inc | $103 - $130 | 4346% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the cash price of $157.00 is significantly lower than the facility's gross charge of $157.00, which aligns with the cash median. While many insurance plans have negotiated rates, the data indicates that for some payers, the negotiated amount of $34.00 is lower than the cash price, suggesting that paying out-of-pocket might be more cost-effective for patients with high-deductible plans. However, patients should verify their specific plan's allowed amount before scheduling, as some commercial payers may have negotiated rates that exceed the cash price due to administrative costs and contract structures. It is also important to note that while the facility is in-network for many plans, balance billing could still occur for out-of-network ancillary services, though the No Surprises Act provides protections for emergency and non-emergency care at in-network facilities.
When evaluating the facility's pricing, it is essential to compare rates against objective benchmarks rather than the hospital's inflated list prices. The Medicare amount for this service is $2.37, which serves as a scientifically validated baseline for the true cost of care. The facility's cash price is 14.3% higher than the Medicare rate, which falls within the typical range where fair pricing is often defined as 120% to 150% of the Medicare amount. Patients should request an itemized billing audit to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. Additionally, asking about prompt-pay discounts before check-in can provide further savings, as these upfront payment incentives can reduce bills by 20% to 5