CMS Price Transparency Data

Blood test, hemoglobin

Facility: Lane County Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $30
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 12.66x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Lane County Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 12.66x the Medicare baseline. Located in 235 West Vine Po Box 969, Dighton, KS.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $30 (1266%)
Insurance Median: $30 (1266%)
Cash: $30 (1266% of Medicare)
Ins. Median: $30 (1266% 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 1266% of the Medicare baseline (a markup of 1166%). 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
Aetna $27 - $28 1139%
UnitedHealthcare $27 - $30 1139%
Healthy Blue Mcaid $30 1266%
Healthy Blue Mcr Adv - All Other Plans $30 1266%
Medicaid / KanCare $30 - $33 1266%
Wppa Providers-All Plans $45 1899%

Consumer Guidance & Cost Commentary

For the blood test for hemoglobin (CPT 85018) at Lane County Hospital in Dighton, KS, the cash price is $30.00, which matches the facility's negotiated rate and the median amount paid across all payers. This rate is significantly higher than the Medicare benchmark of $2.37, reflecting a markup of 12.7 times the federal baseline. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates between $27 and $33, these figures often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing a prompt-pay discount before the insurance claim is processed.

It is important to note that the facility is a Critical Access Hospital owned by a Government Hospital District, and while the state and county averages are not explicitly listed in this specific dataset, the Medicare rate serves as the objective cost baseline for evaluating pricing fairness. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate may be unnecessary if the deductible has not yet been met. To ensure you are receiving the best possible price, we recommend contacting the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance billing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 235 West Vine Po Box 969, Dighton, KS 67839
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals