Blood test, hemoglobin
Facility: Stevens County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $26
- Cash Discount Price: $40
- vs. Medicare Baseline: 10.97x 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 1097% of the Medicare baseline (a markup of 997%). 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 | $9 - $10 | 380% |
| Aetna | $15 - $40 | 633% |
| Humana | $15 | 633% |
| First Health - All Plans | $36 | 1519% |
| Wppa - All Plans | $38 | 1603% |
| Medicaid / KanCare | $40 | 1688% |
Consumer Guidance & Cost Commentary
For the blood test (hemoglobin) at Stevens County Hospital in Hugoton, Kansas, the facility's cash price is $40.00, which matches the gross chargemaster rate. While the median amount paid by insurance plans is $26.00, this negotiated rate is significantly higher than the Medicare benchmark of $2.37, reflecting the typical administrative markup inherent in commercial contracts. For patients with high-deductible plans or those without insurance, paying the full cash price of $40.00 upfront may be more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can reduce the final bill by 20% to 50% by bypassing expensive claims processing fees.
This service is provided by a Critical Access Hospital with a government-local ownership structure, and the facility has a rating of 4. While the data does not provide specific county or state average rates for comparison, the disparity between the Medicare benchmark and the commercial negotiated rate highlights the importance of understanding the true cost baseline. If a patient receives an itemized bill that includes unexpected charges or appears to be a summary bill rather than a detailed statement, they should request a full itemized audit to identify errors, unbundled codes, or services not rendered. Under federal protections like the No Surprises Act, patients should also be cautious about signing waivers that allow out-of-network providers to balance bill them, and any disputed charges should be formally addressed in writing to ensure accurate resolution.