Blood test, hemoglobin
Facility: Ashland Health Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $14
- Cash Discount Price: $11
- vs. Medicare Baseline: 5.91x 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 591% of the Medicare baseline (a markup of 491%). 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 | $5 | 211% |
| Compalliance-All Plans | $11 | 464% |
| Health Partners Of Kansas-All Plans | $12 | 506% |
| Medica Mcare - All Plans | $14 | 591% |
| Health Choice-All Plans | $14 | 591% |
| Aetna | $14 | 591% |
| UnitedHealthcare | $14 | 591% |
| Multiplan-All Plans | $14 | 591% |
| Healthy Blue Mcr Adv - All Other Plans | $14 | 591% |
| Medicare (plans) | $14 | 591% |
| Medicaid / KanCare | $14 | 591% |
| Providers Care (Wppa)-All Plans | $21 | 886% |
Consumer Guidance & Cost Commentary
For this blood test service at Ashland Health Center, the facility's cash price of $11.00 is lower than the state average of $14.00, which is also the median negotiated rate for most major payers including Blue Cross Blue Shield and UnitedHealthcare. While commercial insurance contracts often result in higher allowed amounts than cash prices, patients with high-deductible plans may find paying the cash rate directly more cost-effective if their out-of-pocket expenses exceed the insurance allowed amount. It is important to note that while the facility is a Critical Access Hospital in Kansas, the cash price remains the baseline for self-pay patients, and any potential "prompt-pay" discounts should be requested directly from the billing department before scheduling to ensure the lowest possible out-of-pocket cost.
The Medicare benchmark for this procedure is $2.37, which serves as a strict baseline for evaluating pricing fairness; commercial rates are significantly higher due to administrative costs and contract structures. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their itemized bills carefully to ensure no unbundled charges or services not rendered are included. If a patient receives a summary bill, they should demand a full line-by-line statement to identify any errors, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit dispute sent to the billing supervisor.