Blood test, hemoglobin
Facility: Kansas City Orthopaedic Institute
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $27
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 11.39x 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 1139% of the Medicare baseline (a markup of 1039%). 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 |
|---|---|---|
| Aetna | $2 | 84% |
| Cigna | $2 - $46 | 84% |
| UnitedHealthcare | $2 - $53 | 84% |
| Blue Cross Blue Shield | $4 - $58 | 169% |
| Medica | $27 - $50 | 1139% |
Consumer Guidance & Cost Commentary
For the blood test procedure (CPT 85018) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rate is $27.00, which is significantly lower than the commercial average of $52.00. This facility is a physician-owned acute care hospital in a rural area, where the negotiated rate of $27.00 is notably lower than the state average of $27.00. While the facility's negotiated rate is lower than the state average, the cash price is not available in this dataset. Patients with high-deductible plans should be aware that paying cash upfront might be cheaper if the insurance negotiated rate exceeds the cash price, though current data does not show a cash price for this service.
To avoid unexpected costs, patients should verify their insurance status before scheduling, as commercial rates often include administrative overhead that can inflate the baseline price by 20% to 40%. If a patient receives care from an out-of-network provider, they may face balance billing for the difference between the provider's full chargemaster rate and the amount their insurance allowed, a practice that is now restricted for emergency care and non-emergency services at in-network facilities under the No Surprises Act. Additionally, patients should request a full itemized bill to identify any errors, such as unbundled codes or services not rendered, since over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.