Blood test, hemoglobin
Facility: Stanton County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $36
- Cash Discount Price: $28
- vs. Medicare Baseline: 15.19x 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 1519% of the Medicare baseline (a markup of 1419%). 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 - $230 | 380% |
| Healthy Blue Mcr Adv - All Other Plans | $36 - $238 | 1519% |
| Healthy Blue Mcaid | $37 - $207 | 1561% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Stanton County Hospital, the cash price of $28.00 is identical to the facility's median negotiated rate, which is also $28.00. This suggests that for patients without insurance, paying cash directly is the most cost-effective option. While the facility's cash rate matches the state average, it is significantly lower than the median negotiated rates paid by major payers like Blue Cross Blue Shield ($36.00) and Healthy Blue Mcr Adv ($36.00). If you have a high-deductible plan, paying the $28.00 cash price upfront may save you money compared to your insurance paying the higher negotiated rate, especially if your deductible has not yet been met.
Patients should be aware that commercial insurance contracts often result in higher costs than cash payments due to administrative overhead and multi-layered billing structures. Although the facility is a Critical Access Hospital owned by the local government, the standard negotiated rates for this service exceed the Medicare benchmark of $2.37 by a wide margin. To ensure you are receiving the best possible price, we recommend asking the hospital specifically about "self-pay" or "prompt-pay" discounts before scheduling your visit. These discounts can further reduce the bill by offering immediate liquidity incentives, and you should verify your plan's allowed amount to confirm whether the cash price is indeed lower than what your insurer would negotiate.