Blood test, hemoglobin
Facility: Kiowa District Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $21
- Cash Discount Price: $18
- vs. Medicare Baseline: 8.86x 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 886% of the Medicare baseline (a markup of 786%). 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 |
|---|---|---|
| Healthchoice-All Plans | $4 | 169% |
| Tricare | $9 | 380% |
| Blue Cross Blue Shield | $10 | 422% |
| UnitedHealthcare | $18 - $22 | 759% |
| Health Partners Of Ks-All Plans | $19 | 802% |
| Humana | $20 | 844% |
| Medicare (plans) | $21 | 886% |
| Gbs Insurance - All Plans | $21 | 886% |
| Multiplan-All Plans | $21 | 886% |
| Aetna | $21 | 886% |
| Triwest-All Plans | $21 | 886% |
| Medicaid / KanCare | $22 | 928% |
| Providers Care (Wppa)-All Plans | $33 | 1392% |
| Liberty Healthshare-All Plans | $36 | 1519% |
Consumer Guidance & Cost Commentary
For the blood test, hemoglobin service (CPT 85018) at Kiowa District Hospital in Kiowa, Kansas, the cash median price is $18.00, which is lower than the state average of $21.00. While many commercial payers have negotiated rates that average $21.00, patients with high-deductible plans may find paying the cash price directly more cost-effective, as the cash rate is already below the typical insurance negotiated amount. It is important to note that while the facility is a Critical Access Hospital owned by a Government Hospital District, patients should verify their specific plan details before scheduling, as some in-network contracts may still result in higher out-of-pocket costs than the cash price if the patient has not yet met their deductible.
The Medicare benchmark for this service is $2.37, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $18.00 represents a significant increase over the Medicare rate, reflecting the administrative costs and profit margins inherent in commercial billing. Patients should be aware that hospitals often offer prompt-pay discounts for self-pay patients who settle their bill upfront, which can further reduce the final amount owed. If a patient receives a bill that includes charges for services not rendered or unbundled components, they should request a formal itemized audit to ensure accuracy, as over 80% of hospital bills contain errors that can be corrected through written dispute.