Blood test, hemoglobin
Facility: Community Memorial Healthcare, Inc.
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $11
- Cash Discount Price: $18
- vs. Medicare Baseline: 4.64x 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 464% of the Medicare baseline (a markup of 364%). 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 | $7 - $19 | 295% |
| UnitedHealthcare | $9 - $14 | 380% |
| Blue Cross Blue Shield | $10 | 422% |
Consumer Guidance & Cost Commentary
For the blood test for hemoglobin (CPT 85018) at Community Memorial Healthcare, Inc. in Marysville, KS, the cash median price is $18.00, which matches the facility's gross charge. This rate is significantly lower than the state average, as indicated by a 4.6% variance compared to Medicare's benchmark of $2.37. While the facility's negotiated rates with major payers like Aetna, UnitedHealthcare, and Blue Cross Blue Shield range from $7.00 to $19.00 depending on the specific plan, the cash price remains competitive. Patients with high-deductible plans may find paying the full cash price upfront more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount due to administrative overhead and claim processing costs.
To maximize savings, patients should proactively ask about "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, bypassing the administrative fees associated with insurance claims. It is also important to request an itemized bill before paying, as summary invoices may hide unbundled charges or services not rendered, which are common sources of billing errors. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their specific plan details and deductible status to ensure they are not paying more than necessary. For this procedure, the facility's voluntary non-profit status and critical access hospital designation may offer additional flexibility in payment arrangements.