Blood test, hemoglobin
Facility: Menorah Medical Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $23
- Cash Discount Price: $135
- vs. Medicare Baseline: 9.70x 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 970% of the Medicare baseline (a markup of 870%). 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 - $121 | 42% |
| Celtic | $2 | 84% |
| Wellcare | $2 | 84% |
| Home State Health Plan | $2 | 84% |
| Coventry | $2 - $61 | 84% |
| Amerigroup | $2 | 84% |
| Humana | $2 - $6 | 84% |
| Healthyblue | $2 | 84% |
| Triwest Health Alliance | $2 | 84% |
| Aetna | $2 - $77 | 84% |
| United | $2 - $68 | 84% |
| Medicaid / KanCare | $2 | 84% |
| Unicare | $2 | 84% |
| Devoted Health | $2 | 84% |
| Blue Cross Blue Shield | $2 - $68 | 84% |
| Pyramid Life | $3 | 127% |
| Oscar | $4 | 169% |
| Multiplan | $4 - $112 | 169% |
| Corvel Corporation | $5 - $99 | 211% |
| Oha Network | $5 - $76 | 211% |
| Ambetter / Centene | $22 - $28 | 928% |
| Nhc Advantage | $23 - $29 | 970% |
| Wppa Providrs Care Network | $24 - $30 | 1013% |
| Universal Healthcare | $42 - $53 | 1772% |
| Coventry Kc Mo | $49 - $62 | 2068% |
| College Park Family Care Center | $51 - $65 | 2152% |
| Cco, Inc. | $89 - $114 | 3755% |
| Focus Healthcare Mgmt, Inc | $89 - $114 | 3755% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Menorah Medical Center in Overland Park, KS, the cash price is $135.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by the 9.7% variance against Medicare benchmarks, though it is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures. While the facility offers a negotiated rate of $23.00 for in-network plans, patients with high-deductible plans or those without insurance may find the cash price more favorable, as paying upfront can sometimes result in lower out-of-pocket costs compared to the administrative fees embedded in insurance billing. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed.
Understanding the billing landscape is crucial for avoiding unexpected costs, particularly regarding balance billing and itemized audits. Although the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, it is vital to ensure that ancillary services like laboratory tests are covered under the same network protections. If a patient receives a bill that appears to be a summary invoice rather than a detailed itemized statement, they should request a full line-by-line breakdown to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit. By comparing rates against the objective baseline of Medicare and refusing to sign away rights regarding out-of-network protections, patients can ensure they are paying fair market value rather than inflated chargemaster lists.