Blood test, hemoglobin
Facility: Great Plains Of Sabetha
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $17
- Cash Discount Price: $20
- vs. Medicare Baseline: 7.17x 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 717% of the Medicare baseline (a markup of 617%). 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 |
|---|---|---|
| Medicaid / KanCare | $2 - $20 | 84% |
| UnitedHealthcare | $2 - $20 | 84% |
| Aetna | $2 - $20 | 84% |
| Celtic Mcr Adv | $2 - $10 | 84% |
| Celtic Comm Exchange-All Other Plans | $3 - $13 | 127% |
| Blue Cross Blue Shield | $9 - $20 | 380% |
| Great West Healthcare-All Plans | $17 | 717% |
| Century/Wppa/Providers-All Plans | $18 - $19 | 759% |
| Cigna | $19 | 802% |
| Federated Mutual Ins-All Plans | $19 | 802% |
| Humana | $19 | 802% |
| Multiplan-Phcs-All Plans | $19 | 802% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Great Plains Of Sabetha, the cash price is $20.00, which matches the facility's median negotiated rate of $17.00 and the cash median reported in the data. While the facility is a Critical Access Hospital in Sabetha, Kansas, the data does not provide specific county or state average figures for this service, so a direct comparison to regional benchmarks is not possible from the available information. However, it is important to note that commercial insurance plans, such as Medicaid / KanCare and UnitedHealthcare, negotiate rates that can sometimes exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find that paying the $20.00 cash price upfront is more cost-effective than relying on insurance, which could result in higher allowed amounts or out-of-pocket costs if the deductible has not been met.
To minimize potential costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling the test, as these programs often offer immediate fee reductions for upfront payment. Additionally, if a patient receives a bill from an out-of-network provider or encounters unexpected charges, they should avoid paying immediately and instead request an itemized billing audit to identify errors or unbundled codes. Under federal protections like the No Surprises Act, patients are generally shielded from balance billing for emergency services or non-emergency care at in-network facilities, but verifying the network status and disputing any unauthorized charges in writing is essential to prevent surprise debt.