Blood test, hemoglobin
Facility: Hospital District #6 Patterson Health Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $17
- Cash Discount Price: $14
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $9 - $10 | 380% |
| UnitedHealthcare | $14 - $20 | 591% |
| Providers Care (Wppa)-All Plans | $26 - $35 | 1097% |
Consumer Guidance & Cost Commentary
For this blood test procedure at the Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash price of $14.00 is lower than the state average, while the median negotiated rate of $17.00 reflects typical commercial insurance contracts. Patients with high-deductible plans may find paying the $14.00 cash price directly more cost-effective than relying on insurance, which often results in higher out-of-pocket costs if the negotiated rate exceeds the cash price. To minimize expenses, it is advisable to contact the hospital directly to confirm availability of "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
The Medicare benchmark for this service is $2.37, providing a clear baseline to evaluate pricing fairness; the facility's gross charge of $18.00 significantly exceeds this federal rate, highlighting the importance of comparing commercial rates against Medicare rather than the inflated chargemaster list. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to request an itemized audit to identify errors such as unbundled codes or services not rendered, and you may also be protected under the No Surprises Act from balance billing for emergency or non-emergency services at in-network facilities. Always dispute any surprise bills in writing and demand a full, line-by-line statement before agreeing to pay.