Blood test, hemoglobin
Facility: Kiowa County Memorial Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $80
- Cash Discount Price: $77
- vs. Medicare Baseline: 33.76x 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 3376% of the Medicare baseline (a markup of 3276%). 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 - $80 | 422% |
| UnitedHealthcare | $72 - $90 | 3038% |
| Health Partners Of Ks-All Plans | $79 | 3333% |
| Aetna | $80 | 3376% |
| Celtic Comml Exchange-All Other Plans | $80 | 3376% |
| Medica Prime Mcare Cost-All Plans | $80 | 3376% |
| Humana | $80 | 3376% |
| Medicaid / KanCare | $90 | 3797% |
| Providrs Care/Wppa-All Plans | $135 | 5696% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Kiowa County Memorial Hospital, the facility's cash price of $77.00 is lower than the state average of $80.00, making it a cost-effective option for patients paying out-of-pocket. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $72.00 to $90.00, these amounts are generally higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans or those without insurance may find the cash price more favorable, as paying directly can sometimes result in lower total costs compared to insurance negotiated rates that include processing fees. It is important to note that while Medicaid/KanCare and other public plans have fixed rates of $90.00, self-pay patients should explicitly ask the hospital about prompt-pay discounts, which can further reduce the final bill by 20% to 50% if paid in full upfront.
The facility's pricing is significantly lower than the Medicare benchmark of $2.37 when adjusted for the specific service context, though the gross chargemaster rate of $90.00 serves as the inflated baseline often used for comparison. Commercial insurance contracts typically cap payments between 120% and 150% of the true cost, whereas this facility's negotiated rates align closely with the median paid amount of $80.00 across most plans. To ensure you are not overcharged, always request an itemized bill that lists specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled charges.