Blood test, hemoglobin
Facility: Wichita County Health Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $15
- Cash Discount Price: $13
- vs. Medicare Baseline: 6.33x 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 633% of the Medicare baseline (a markup of 533%). 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 |
|---|---|---|
| Medicaid / KanCare | $13 | 549% |
| UnitedHealthcare | $16 | 675% |
Consumer Guidance & Cost Commentary
For this blood test for hemoglobin at Wichita County Health Center in Leoti, Kansas, the facility's cash price is $13.00, which matches the median negotiated rate of $15.00 and the median paid amount of $13.00. While the facility is in-network for Medicaid/KanCare and UnitedHealthcare, patients should be aware that cash payment can sometimes be more cost-effective than insurance claims, particularly if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. The facility offers a government-owned status as a Critical Access Hospital, and while the specific cash discount percentage is not listed, patients are encouraged to ask directly about "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront to avoid administrative fees and bad debt costs.
When evaluating the cost against broader benchmarks, the Medicare amount for this service is $2.37, which serves as a baseline for fair pricing. The facility's negotiated rate of $15.00 is significantly higher than the Medicare amount, reflecting the standard administrative markup associated with commercial insurance contracts. Although specific county or state average data for this code is not provided in the current dataset, it is important to note that commercial rates often range from 200% to 300% of the Medicare amount, whereas fair pricing is typically defined as 120% to 150%. To ensure you are receiving the best possible rate, patients should request an itemized bill to verify that no services were unbundled or double-charged, and they should confirm their deductible status before scheduling to avoid unexpected out-of-pocket expenses.