Blood test, hemoglobin
Facility: Republic County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $20
- Cash Discount Price: $17
- vs. Medicare Baseline: 8.44x 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 844% of the Medicare baseline (a markup of 744%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $19 | 802% |
| UnitedHealthcare | $20 | 844% |
| Aetna | $20 | 844% |
| Meritain-All Plans | $20 | 844% |
| First Health-All Plans | $21 | 886% |
| Cigna | $21 | 886% |
| Midlands Choice-All Plans | $21 | 886% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the facility's cash price of $17.00 is lower than the state average of $22.00, making it a cost-effective option for patients paying out-of-pocket. While the median negotiated rate for in-network insurance is $20.00, which is slightly higher than the cash price, patients with high-deductible plans may find that paying the cash rate upfront is more financially advantageous. To secure the best possible price, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
The Medicare benchmark for this service is $2.37, which serves as a baseline for evaluating the facility's pricing structure. Although the commercial negotiated rates are significantly higher than the Medicare amount, this markup is standard for commercial insurance contracts that include administrative processing costs. If you receive a bill that exceeds the negotiated rate, you may be subject to balance billing if the provider is out-of-network, though the No Surprises Act protects patients from such surprise charges for emergency care and non-emergency services at in-network facilities. Always request a full itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.