Blood test, hemoglobin
Facility: Holton Community Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $15
- Cash Discount Price: $14
- 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 |
|---|---|---|
| Kansas Superior Select - All Plans | $4 - $17 | 169% |
| Humana | $4 - $17 | 169% |
| UnitedHealthcare | $4 - $32 | 169% |
| Aetna | $4 - $32 | 169% |
| Preferred Health Fn Select - All Other Plans | $6 - $27 | 253% |
| Preferred Health Freedom | $6 - $27 | 253% |
| Preferred Health Professionals | $6 - $27 | 253% |
| Medicaid / KanCare | $7 - $32 | 295% |
| Wppa Providers - All Plans | $7 - $31 | 295% |
| Blue Cross Blue Shield | $10 | 422% |
Consumer Guidance & Cost Commentary
For the blood test (CPT 85018) at Holton Community Hospital in Holton, KS, the facility's cash price of $14.00 is lower than the state average, which sits at $15.00. While the hospital's negotiated rates for commercial payers like UnitedHealthcare and Aetna range from $6 to $32, these amounts are generally higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it beneficial to pay the $14.00 cash price directly, as this avoids the higher negotiated rates that insurance carriers pay, provided the patient's deductible has not yet been met. It is important to verify the specific allowed amount with your insurer before scheduling, as in-network rates vary significantly by plan and can sometimes exceed the cash-pay option.
The facility's Medicare benchmark rate for this service is $2.37, which serves as a baseline for evaluating pricing fairness. The hospital's cash price of $14.00 is approximately 6.3 times the Medicare amount, reflecting standard commercial pricing markups. To minimize costs, patients should inquire about "self-pay" or "prompt-pay" discounts before check-in, as paying the bill in full upfront can often reduce the amount owed by 20% to 50%. Additionally, if you receive an itemized bill, request a detailed breakdown of charges to ensure there are no errors or unbundled codes, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit.