Blood test, hemoglobin
Facility: Sheridan County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $13
- Cash Discount Price: $20
- 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 |
|---|---|---|
| Celtic Insurance | $12 | 506% |
| Blue Cross Blue Shield | $13 | 549% |
| UnitedHealthcare | $19 | 802% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Sheridan County Hospital in Hoxie, Kansas, the cash price is $20.00, which matches the facility's cash median. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare range from $12.00 to $19.00. It is important to note that for patients with high-deductible plans, paying cash at the $20.00 rate may be more cost-effective than relying on insurance, as the negotiated rates for these specific plans can exceed the cash price. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which could further reduce the final amount owed before any insurance processing occurs.
When evaluating the cost against broader benchmarks, the Medicare amount for this service is $2.37, which serves as the objective baseline for fair pricing. The facility's cash rate of $20.00 represents a significant markup compared to the Medicare benchmark, a common characteristic of commercial billing structures where negotiated rates often average 200% to 300% of the Medicare rate. While the data does not provide specific state or county average comparisons for this exact code, understanding the Medicare rate helps patients identify if the commercial charges are reasonable relative to the true cost of care. To ensure you are not overcharged, it is advisable to request an itemized bill that breaks down the specific CPT code and avoids summary billing, allowing you to confirm that no unbundled charges or services not rendered have inflated the total.