Blood test, hemoglobin
Facility: Grisell Memorial Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $22
- Cash Discount Price: $23
- vs. Medicare Baseline: 9.28x 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 928% of the Medicare baseline (a markup of 828%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $9 | 380% |
| UnitedHealthcare | $16 - $20 | 675% |
| Humana | $22 - $316 | 928% |
| Medicaid / KanCare | $22 - $26 | 928% |
Consumer Guidance & Cost Commentary
For the blood test procedure (CPT 85018) at Grisell Memorial Hospital in Ransom, Kansas, the cash median price is $23.00, which is slightly lower than the facility's negotiated rate of $22.00. This test is covered by four payers, with rates ranging from $9 to $316 depending on the specific plan. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that cash payments can sometimes be more cost-effective than using insurance, particularly if the insurance negotiated rate exceeds the cash price. Since the cash rate is already competitive, patients with high-deductible plans may find it beneficial to pay directly, provided they confirm the facility's self-pay or prompt-pay discounts before scheduling.
When evaluating the cost against federal benchmarks, the Medicare amount for this service is $2.37, and the facility's cash rate is approximately 9.3 times higher than the Medicare benchmark. This significant markup is common in commercial pricing, where negotiated rates often reflect administrative costs and contract dynamics rather than the base cost of care. To ensure you are receiving a fair price, it is recommended to request an itemized billing audit rather than accepting a summary bill, as detailed statements can reveal errors or unbundled charges. Additionally, if you have a balance bill from an out-of-network provider, you may be entitled to protections under the No Surprises Act, which prevents you from paying the difference between the provider's rate and your insurance allowed amount for certain services.