CMS Price Transparency Data

Blood test, hemoglobin

Facility: Kansas Spine & Specialty Hospital, Llc

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $2
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Kansas Spine & Specialty Hospital, Llc is $2. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 0.84x the Medicare baseline. Located in 3333 North Webb Road, Wichita, KS.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$2

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $17 (717%)
Insurance Median: $2 (84%)
Cash: $17 (717% of Medicare)
Ins. Median: $2 (84% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Providrs Care Network $2 84%
United Mine Workers Of America $2 84%
Blue Cross Blue Shield $2 84%
UnitedHealthcare $2 - $3 84%
Humana $2 84%
Aetna $2 - $3 84%
Lantern Specialty Care $4 169%

Consumer Guidance & Cost Commentary

For the blood test, hemoglobin (CPT 85018) at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the cash median price is $17.00, which is significantly lower than the facility's negotiated rates of $2.00 and the Medicare benchmark of $2.37. While the facility is owned by a physician and serves seven payers including UnitedHealthcare and Aetna, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rates exceed this amount. It is important to note that commercial rates often include administrative overhead and contract dynamics that can inflate the baseline price, so comparing directly to the Medicare rate provides a clearer picture of the true cost of delivery rather than relying on the hospital's gross charge.

Before scheduling, patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payments. Since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can avoid unexpected charges by ensuring their provider is properly classified. If a discrepancy arises, requesting a formal, itemized billing audit is the most effective way to identify errors or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected through written dispute to the billing supervisor.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 North Webb Road, Wichita, KS 67226
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals