Blood test, hemoglobin
Facility: Logan County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $34
- Cash Discount Price: $10
- 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% |
| Humana | $21 | 886% |
| Health Partners - All Plans | $48 | 2025% |
| Medicaid / KanCare | $50 | 2110% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Logan County Hospital in Oakley, Kansas, the negotiated rates for major payers like Blue Cross Blue Shield and Humana are $10 and $21, respectively, while the cash price is significantly lower at $10. It is important to note that while insurance often covers the full negotiated amount, patients with high-deductible plans may find paying the cash price upfront to be more cost-effective, as the cash rate is already below the negotiated fees. Additionally, patients should inquire about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full within 30 days, effectively bypassing the administrative costs associated with insurance claims processing.
When evaluating the value of this service, it is helpful to compare the facility's pricing against established benchmarks. The facility's cash rate of $10 is notably lower than the state average for this procedure, which is $34.00, and also lower than the median negotiated rate of $34.00 reported for the region. Furthermore, the facility's rate is 14.3% higher than the Medicare benchmark of $2.37, which serves as the objective baseline for healthcare costs. Given that the facility is a Critical Access Hospital owned by the local government, patients should request an itemized bill to ensure no errors exist and verify if any additional "self-pay" or "prompt-pay" discounts are available before finalizing payment.