Blood test, hemoglobin
Facility: Rooks County Health Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $34
- Cash Discount Price: $28
- vs. Medicare Baseline: 14.35x 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 1435% of the Medicare baseline (a markup of 1335%). 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% |
| Veterans Admin - All Plans | $18 | 759% |
| Celtic Mcr Adv | $18 | 759% |
| Tricare | $18 | 759% |
| Celtic Comm - All Other Plans | $19 | 802% |
| Aetna | $34 | 1435% |
| Preferred Benefits Admin | $34 | 1435% |
| UnitedHealthcare | $34 | 1435% |
| Preferred Hlthcare - All Other Plans | $35 | 1477% |
| Health Partners - All Plans | $35 | 1477% |
| Healthy Blue Mcaid - All Plans | $37 | 1561% |
Consumer Guidance & Cost Commentary
This blood test for hemoglobin at Rooks County Health Center in Plainville, Kansas, carries a cash price of $28.00, which is lower than the facility's negotiated rates of $34.00 and significantly below the state average of $37.00. While the Medicare benchmark for this service is only $2.37, commercial insurance plans typically pay negotiated rates ranging from $10.00 to $37.00 depending on the specific carrier. For patients with high-deductible plans, paying the cash price of $28.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront incentives can further reduce the final cost.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. If you receive a bill that seems higher than expected, request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Avoid signing consent waivers that waive your rights to dispute out-of-network charges, and always dispute any surprise bills in writing rather than paying immediately out of fear of credit damage. By comparing the facility's rates to the Medicare benchmark and understanding the difference between cash and negotiated pricing, you can make informed decisions about your healthcare spending.