Blood test, hemoglobin
Facility: Wilson Medical Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $14
- Cash Discount Price: $14
- vs. Medicare Baseline: 5.91x 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 591% of the Medicare baseline (a markup of 491%). 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 |
|---|---|---|
| UnitedHealthcare | $8 - $20 | 338% |
| Ambetter / Centene | $8 - $21 | 338% |
| Tricare | $8 - $11 | 338% |
| Humana | $8 - $11 | 338% |
| Aetna | $8 - $21 | 338% |
| Blue Cross Blue Shield | $10 - $21 | 422% |
| Cigna | $12 - $17 | 506% |
| Mulitplan-All Plans | $14 - $19 | 591% |
| Health Partners-All Plans | $14 - $19 | 591% |
Consumer Guidance & Cost Commentary
For the blood test, hemoglobin service (CPT 85018) at Wilson Medical Center in Neodesha, KS, the facility's cash median rate is $14.00, which is $2.63 higher than the state average. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range between $8.00 and $21.00, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate of $14.00 directly. It is important to note that commercial insurance contracts can sometimes result in higher allowed amounts than cash prices due to administrative costs and contract dynamics, so verifying the specific allowed amount for your plan before scheduling is essential.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To ensure you are not overcharged, request a full itemized bill before paying, as summary bills may hide unbundled codes or services not rendered. Additionally, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the $14.00 cash rate further by bypassing insurance claims processing fees. Finally, compare all charges against the Medicare benchmark of $2.37; since commercial rates are often significantly higher than this federal baseline, using the Medicare amount as a reference point helps identify if the negotiated or cash rates are appropriately marked up.