Blood test, hemoglobin
Facility: Clara Barton Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $32
- Cash Discount Price: $25
- vs. Medicare Baseline: 13.50x 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 1350% of the Medicare baseline (a markup of 1250%). 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% |
| 6 Degrees Health - All Plans | $24 | 1013% |
| Wppa-All Plans | $28 | 1181% |
| Phcs - All Plans | $32 | 1350% |
| Aetna | $32 | 1350% |
| Hlth Partners Of Ks-All Plans | $32 | 1350% |
| UnitedHealthcare | $32 | 1350% |
Consumer Guidance & Cost Commentary
For the blood test, hemoglobin service (CPT 85018) at Clara Barton Hospital in Hoisington, KS, the facility's cash median price is $25.00, which is lower than the state average of $26.00. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $10 to $32, patients with high-deductible plans may find paying the cash price directly more cost-effective, as the cash rate is already below the state average. It is important to note that commercial negotiated rates often include administrative overhead and can exceed cash prices, so verifying the specific allowed amount for your plan before scheduling is essential to avoid unexpected costs.
The facility's Medicare benchmark of $2.37 serves as a baseline for evaluating pricing, with the cash price representing a significant markup over this federal rate. Although the hospital is a Voluntary non-profit Critical Access Hospital, patients should be aware that balance billing can still occur if services are rendered by out-of-network providers, even at an in-network facility, though the No Surprises Act offers protections for emergency and non-emergency care. To ensure you receive the most accurate billing, always request an itemized bill before paying, as summary invoices may obscure individual charges, and consider asking about prompt-pay discounts if you choose to settle the account directly with the hospital.