Blood test, hemoglobin
Facility: Medicine Lodge Memorial Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $16
- Cash Discount Price: $16
- 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 |
|---|---|---|
| Tricare | $13 - $14 | 549% |
| Humana | $14 - $16 | 591% |
| UnitedHealthcare | $15 - $16 | 633% |
| Hpk-All Plans | $15 - $16 | 633% |
| Aetna | $15 - $17 | 633% |
| Medicaid / KanCare | $16 - $17 | 675% |
Consumer Guidance & Cost Commentary
For the blood test for hemoglobin (CPT 85018) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $16.00, which matches the facility's median negotiated rate and the state average. This service is significantly more affordable than the Medicare benchmark of $2.37, reflecting the typical markup found in commercial billing. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying cash upfront to be the most cost-effective option, as the cash price is already at the negotiated floor. It is important to verify if the hospital offers a prompt-pay discount for self-pay patients, which could further reduce the final amount owed.
Patients should be aware that insurance plans like Tricare, Humana, and UnitedHealthcare have negotiated rates ranging from $13 to $17, which are generally higher than the cash price due to administrative costs and claim processing fees. If you have insurance, ensure you explicitly request a waiver of insurance submission before your appointment to avoid automatic claims that could void any potential cash discounts. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, you can rest assured that you will not be billed for the difference between the provider's full charge and your insurance allowed amount for this service. Always request an itemized bill before paying to confirm that all charges align with the negotiated or cash rates listed above.