Blood test, hemoglobin
Facility: Saint Luke'S South Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $4
- Cash Discount Price: $83
- vs. Medicare Baseline: 1.69x 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 |
|---|---|---|
| Cigna | $2 - $106 | 84% |
| Humana | $2 - $4 | 84% |
| UnitedHealthcare | $2 - $3 | 84% |
| Aetna | $2 - $132 | 84% |
| Medicaid / KanCare | $2 - $3 | 84% |
| Transplants-Case Rates [5750] | $3 - $139 | 127% |
| Blue Cross Blue Shield | $3 - $104 | 127% |
| Commercial-Contracted [8000] | $4 - $112 | 169% |
| First Health [5512] | $82 | 3460% |
Consumer Guidance & Cost Commentary
For the CPT code 85018, representing a blood test for hemoglobin at Saint Luke's South Hospital in Overland Park, KS, the facility's cash median rate is $83.00, which is significantly lower than the negotiated rates paid by most insurance plans. While the facility's negotiated median is $4.00, this figure appears to be an outlier or error in the provided dataset compared to the gross charge of $139.00 and the wide range of negotiated amounts seen across payers like Aetna ($2–$132) and Blue Cross Blue Shield ($2–$104). Generally, commercial insurance contracts often result in higher final costs for patients due to administrative overhead and multi-layered pricing structures, whereas paying cash upfront can sometimes be more cost-effective, especially for those with high-deductible plans. Patients should verify if their specific plan has a deductible that would make the insurance allowed amount higher than the $83.00 cash price, and they are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts that could further reduce the bill.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this procedure is $2.37, and the facility's cash rate of $83.00 represents a markup of 1.7 times the Medicare rate, which falls within the typical range where commercial rates average 200% to 300% of Medicare. If a patient has out-of-network coverage or receives care for services that trigger balance billing, they may face