Blood test, hemoglobin
Facility: Ellsworth County Medical Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $16
- Cash Discount Price: $19
- vs. Medicare Baseline: 6.75x 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 675% of the Medicare baseline (a markup of 575%). 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 | $8 - $10 | 338% |
| Healthy Blue Mcr Adv | $8 - $10 | 338% |
| Humana | $8 - $20 | 338% |
| Triwest -All Plans | $8 - $10 | 338% |
| Blue Cross Blue Shield | $9 - $10 | 380% |
| UnitedHealthcare | $11 - $21 | 464% |
| Aetna | $15 - $19 | 633% |
| First Health - All Plans | $15 - $19 | 633% |
| Medicaid / KanCare | $16 - $21 | 675% |
| Cigna | $16 - $20 | 675% |
| Coventry Mcaid-All Plans | $16 - $21 | 675% |
| Healthy Blue Mcaid- All Other Plans | $16 - $21 | 675% |
| Providers Care-Wppa-All Plans | $25 - $32 | 1055% |
Consumer Guidance & Cost Commentary
For the blood test for hemoglobin (CPT 85018) at Ellsworth County Medical Center in Ellsworth, Kansas, the cash price is $19.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $2.37, indicating a markup of 6.8 times the federal baseline. While the facility is a Critical Access Hospital with a proprietary ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract dynamics. For instance, UnitedHealthcare's negotiated rate ranges from $11 to $21, and Medicaid/McAid plans range from $16 to $21, both surpassing the cash price. However, if a patient has a high-deductible plan that has not yet met their out-of-pocket maximum, paying the cash price of $19.00 upfront could be more cost-effective than relying on insurance, which may result in higher allowed amounts before the deductible is satisfied.
To minimize costs, patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full before or shortly after services are rendered. It is also important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected. While the facility's negotiated rates vary by payer, with UnitedHealthcare showing the widest range ($11–$21) and some plans like Va Ccn-All Plans having a lower range ($8–