Blood test, hemoglobin
Facility: Stafford County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $52
- Cash Discount Price: $55
- vs. Medicare Baseline: 21.94x 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 2194% of the Medicare baseline (a markup of 2094%). 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 |
|---|---|---|
| Va Ccn-All Plans | $1 | 42% |
| UnitedHealthcare | $1 | 42% |
| Health Partners-All Plans | $52 | 2194% |
| Medica Mcr- All Plans | $55 | 2321% |
| Humana | $55 | 2321% |
Consumer Guidance & Cost Commentary
For this blood test, the cash price of $55.00 is identical to the median negotiated rate paid by in-network insurers, including UnitedHealthcare and Health Partners. This parity suggests that paying out-of-pocket may be the most cost-effective option for patients with high-deductible plans, as the cash price avoids the administrative overhead often embedded in commercial contracts. While the facility's negotiated rate of $52.00 is slightly lower than the cash price, it remains significantly higher than the Medicare benchmark of $2.37, indicating a substantial markup relative to the federal cost baseline. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated amount may not be covered until that threshold is met.
To ensure you receive the most accurate pricing, always request a self-pay or prompt-pay discount before check-in, as these upfront payments can bypass insurance billing cycles and reduce administrative costs. If you receive a bill after using insurance, do not accept a summary invoice; instead, demand a full itemized statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. Furthermore, be aware of federal protections under the No Surprises Act, which generally prevent balance billing for out-of-network services at in-network facilities, though you should still review any consent forms carefully to avoid inadvertently waiving your rights to dispute unexpected charges.