CMS Price Transparency Data

Blood test, hemoglobin

Facility: Ellinwood District Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $33
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 13.92x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Ellinwood District Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 13.92x the Medicare baseline. Located in 605 N Main Street, Ellinwood, KS.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $40 (1688%)
Insurance Median: $33 (1392%)
Cash: $40 (1688% of Medicare)
Ins. Median: $33 (1392% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1392% of the Medicare baseline (a markup of 1292%). 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.

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
Cigna $32 - $33 1350%
Blue Cross Blue Shield $32 - $33 1350%
Humana $32 - $33 1350%
Aetna $32 - $33 1350%
UnitedHealthcare $32 - $33 1350%

Consumer Guidance & Cost Commentary

For this blood test for hemoglobin at Ellinwood District Hospital, the facility's cash median price is $40.00, while the negotiated rate for in-network insurance is $33.00. This specific service is priced at 13.9% above the Medicare benchmark of $2.37, reflecting the standard administrative markup inherent in commercial billing structures. While the negotiated rate is lower than the cash price, patients with high-deductible plans may find paying the $40.00 cash price more cost-effective if their insurance allowed amount exceeds this figure, as they would otherwise face significant out-of-pocket costs before meeting their deductible. It is important to verify your specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest possible price can lead to unexpected financial burden.

To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the administrative overhead of insurance claims. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement is crucial to identify any unbundled codes or services not rendered before making a payment. This facility is a Critical Access Hospital in Ellinwood, Kansas, and its pricing is based on the 2026-06 data vintage, ensuring transparency for consumers comparing rates against local market standards.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 605 N Main Street, Ellinwood, KS 67526
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals