Blood test, hemoglobin
Facility: Hamilton County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $41
- Cash Discount Price: $45
- vs. Medicare Baseline: 17.30x 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 1730% of the Medicare baseline (a markup of 1630%). 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 - $10 | 211% |
| First Health Coventry - All Plans | $38 | 1603% |
| UnitedHealthcare | $43 | 1814% |
| Cigna | $43 | 1814% |
| Va Ccn - All Plans | $45 | 1899% |
| Aetna | $76 | 3207% |
Consumer Guidance & Cost Commentary
For the blood test for hemoglobin (CPT 85018) at Hamilton County Hospital in Syracuse, KS, the cash price is $45.00, which matches the facility's negotiated rate for most payers. This cash price is significantly higher than the state average for this service, which is $2.37 according to Medicare benchmarks. While Medicare rates represent the federal baseline for the true cost of care, commercial negotiated rates often exceed this due to administrative overhead and contract structures. In this case, the cash price of $45.00 is 17.3% higher than the Medicare amount, illustrating how commercial pricing can deviate from the government's cost-based standard.
Patients should be aware that while insurance plans negotiate rates to protect members, these amounts can sometimes be higher than the cash price, particularly if the patient has a high deductible. For this specific test, the median negotiated rate across payers is $41.00, which is slightly lower than the cash price, but individual plan deductibles could result in higher out-of-pocket costs. To ensure you receive the best possible rate, it is recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, if you receive a summary bill, request a full itemized statement to verify that no unbundled charges or services not rendered have inflated your total.