Blood test, hemoglobin
Facility: Phillips County Hospital
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 | $10 - $242 | 422% |
| UnitedHealthcare | $14 - $17 | 591% |
| Medicaid / KanCare | $17 | 717% |
| Health Partners-All Plans | $17 | 717% |
Consumer Guidance & Cost Commentary
For the CPT code 85018, representing a blood test for hemoglobin at Phillips County Hospital in Phillipsburg, Kansas, the facility's cash median price is $14.00, which aligns with the median paid amount of $14.00. This cash rate is significantly lower than the facility's negotiated rates, where the highest negotiated amount is $17.00 across four payers, including Blue Cross Blue Shield, UnitedHealthcare, Medicaid/KanCare, and Health Partners-All Plans. While the facility is a Critical Access Hospital with government-local ownership, patients should note that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price.
When evaluating costs against broader benchmarks, the facility's cash rate of $14.00 is notably higher than the Medicare amount of $2.37, indicating a substantial markup relative to the federal baseline. However, it is important to distinguish between the gross charge of $17.00 and the actual negotiated or cash prices to avoid confusion with inflated list prices. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services are not covered. To minimize costs, individuals should request a prompt-pay discount if paying out-of-pocket directly, as these upfront payments often bypass administrative fees and provide immediate liquidity benefits to the provider.