Blood test, hemoglobin
Facility: Norton County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $14
- Cash Discount Price: $18
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $14 | 591% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Norton County Hospital, the cash price is $18.00, which is lower than the facility's negotiated rate of $14.00. This suggests that paying out-of-pocket directly may be more cost-effective than using insurance, especially if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. While the facility is a Critical Access Hospital in Norton, KS, with a government-local ownership structure, patients should verify their specific plan details before scheduling. It is important to note that while the facility's cash rate is provided, the median paid amount is not available in the current data, so confirming your out-of-network status or potential balance billing risks is essential if you do not have a contract with Blue Cross Blue Shield.
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 double-billing or unbundled codes. If you receive a surprise bill for the difference between the provider's full charge and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Additionally, since the Medicare benchmark for this service is $2.37, the commercial rates reflect significant markups; comparing your final bill to this federal baseline rather than the hospital's gross charge can help identify if the pricing is fair. Always ask the hospital about prompt-pay discounts upfront, as paying in full within 30 days can often reduce the total cost by 20% to 50%.