Blood test, hemoglobin
Facility: Kansas Medical Center Llc
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $2
- Cash Discount Price: $23
- vs. Medicare Baseline: 0.84x 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 |
|---|---|---|
| Medadv_Wellcare | $2 | 84% |
| Ambetter / Centene | $2 | 84% |
| Humana | $2 | 84% |
| Indian Health | $2 | 84% |
| Blue Cross Blue Shield | $2 - $6 | 84% |
| Medicaid / KanCare | $2 | 84% |
| Three_Rivers | $5 | 211% |
| Wppa | $6 - $24 | 253% |
| Aetna | $7 | 295% |
Consumer Guidance & Cost Commentary
For this blood test at Kansas Medical Center Llc in Andover, the cash price of $23.00 is notably lower than the facility's negotiated rate of $50.00, which is what commercial insurers typically pay. While the facility's negotiated rate is higher than the Medicare benchmark of $2.37, the cash price remains significantly below the gross charge of $38.00. Patients with high-deductible plans may find it beneficial to pay the cash price directly, as the $23.00 rate is lower than the $50.00 amount their insurance would negotiate, potentially saving money if their deductible has not yet been met. It is important to verify this cash price directly with the hospital before scheduling, as self-pay or prompt-pay discounts may apply to reduce the final amount owed.
This service is covered by nine different payers, including major carriers like Humana, Aetna, and Blue Cross Blue Shield, with negotiated rates ranging from $2.00 to $24.00 depending on the specific plan. The facility's negotiated rate of $50.00 is substantially higher than the Medicare amount of $2.37, illustrating the significant markup often found in commercial contracts. To avoid unexpected costs, patients should request an itemized bill and confirm whether any ancillary services, such as emergency physicians or lab components, are out-of-network, which could trigger balance billing despite the facility's in-network status. Always check your specific plan details and ask the billing department about any prompt-pay discounts available before your visit to ensure you are aware of the most accurate pricing.