Blood test, hemoglobin
Facility: Greenwood County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $13
- Cash Discount Price: $12
- vs. Medicare Baseline: 5.49x 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 549% of the Medicare baseline (a markup of 449%). 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 |
|---|---|---|
| Triwest - All Plans | $5 | 211% |
| Tricare | $6 | 253% |
| Choicecare Mcr Adv - All Plans | $6 | 253% |
| Blue Cross Blue Shield | $9 - $10 | 380% |
| Integrated Health Plan - All Plans | $11 | 464% |
| Beech Street - All Plans | $13 | 549% |
| UnitedHealthcare | $13 | 549% |
| First Health - All Other Plans | $13 | 549% |
| First Health Ccn Network | $13 | 549% |
| Preferred Hs (Coventry) - All Plans | $14 | 591% |
| Principal Health Care Inc - All Plans | $14 | 591% |
| Medicaid / KanCare | $15 | 633% |
| Amerigroup Mcaid-All Plans | $15 | 633% |
| Providrs Care/Wppa - All Plans | $22 | 928% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Greenwood County Hospital in Eureka, Kansas, the cash price of $12.00 is lower than the facility's negotiated rates, which range from $5.00 to $22.00 depending on the insurance plan. While the median negotiated amount paid by insurers is $13.00, patients with high-deductible plans might find paying the cash price directly more cost-effective, as the cash rate is already below the average allowed amount. It is important to note that while the facility is a Critical Access Hospital owned by the local government, the specific negotiated rates vary significantly across the 14 payers listed, with some plans like Triwest and Tricare showing a low of $5.00, whereas others such as Providrs Care/Wppa show a high of $22.00.
To ensure you are not overcharged, you should request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a surprise bill that exceeds the No Surprises Act protections, you can dispute it in writing with the insurer rather than paying immediately out of fear of credit damage. Additionally, since the cash price of $12.00 is lower than the Medicare benchmark of $2.37 adjusted for local costs, and the facility offers a prompt-pay discount for upfront payment, contacting the hospital directly to confirm self-pay rates or ask for a prompt-pay reduction could further lower your out-of-pocket expense. Always verify your deductible status before scheduling, as paying the full negotiated rate without meeting your deductible could result in higher costs than paying cash outright.