Blood test, hemoglobin
Facility: Rawlins County Health Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $26
- Cash Discount Price: $26
- vs. Medicare Baseline: 10.97x 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 1097% of the Medicare baseline (a markup of 997%). 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 | $10 | 422% |
| UnitedHealthcare | $26 | 1097% |
Consumer Guidance & Cost Commentary
For this blood test service at Rawlins County Health Center in Atwood, Kansas, the cash price is $26.00, which is slightly lower than the facility's negotiated rate of $26.00 and the state average of $26.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance rates often include administrative overhead that can inflate the final cost. If you have a high-deductible plan, paying the cash price upfront might be more cost-effective than relying on insurance, especially since the negotiated rate does not reflect the actual amount your insurer would pay. It is always advisable to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available before scheduling, as these can further reduce the out-of-pocket expense.
The Medicare benchmark for this procedure is $2.37, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $26.00 represents a significant increase over the Medicare rate, a common occurrence when commercial rates are compared against federal benchmarks. However, the facility's negotiated rate of $26.00 aligns with the state average, suggesting that the pricing structure is consistent with regional standards rather than inflated. To ensure you are not overcharged, we recommend requesting a detailed, itemized bill that lists specific CPT codes to verify that no unbundled charges or services not rendered are included. If you receive a balance bill from an out-of-network provider, you may be entitled to protections under the No Surprises Act, which prevents surprise billing for emergency care and non-emergency services at in-network facilities.