Blood test, hemoglobin
Facility: Cloud County Health Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $28
- Cash Discount Price: $20
- vs. Medicare Baseline: 11.81x 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 1181% of the Medicare baseline (a markup of 1081%). 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 |
|---|---|---|
| Aetna | $26 - $27 | 1097% |
| Health Partners - All Plans | $28 | 1181% |
| Mpi-All Plans | $28 | 1181% |
| Pponext-All Plans | $28 | 1181% |
Consumer Guidance & Cost Commentary
This blood test for hemoglobin at Cloud County Health Center in Concordia, KS, has a cash median price of $20.00, which is lower than the facility's negotiated rate of $28.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans might find paying the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the actual cost of care, making the cash option a potential savings strategy for those who do not require insurance coverage for this specific service.
For patients seeking to minimize costs, it is recommended to explicitly ask the facility about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final bill. Additionally, if you are using insurance, be aware that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, though you should still request an itemized bill to ensure no unbundled charges or services not rendered are included. Comparing this specific code to broader market data, the facility's pricing aligns with the provided payer averages, but always verify your specific plan's allowed amount to avoid unexpected out-of-pocket expenses.