Blood test, hemoglobin
Facility: Hodgeman County Health Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $37
- Cash Discount Price: $42
- vs. Medicare Baseline: 15.61x 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 1561% of the Medicare baseline (a markup of 1461%). 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 | $9 - $10 | 380% |
| UnitedHealthcare | $33 - $49 | 1392% |
| Humana | $33 | 1392% |
| Triwest - All Plans | $33 | 1392% |
| Medicaid / KanCare | $33 - $52 | 1392% |
| Aetna | $42 | 1772% |
| First Health - All Plans | $47 | 1983% |
| Wppa (Provdrscare) - All Plans | $49 | 2068% |
| Health Partners - All Plans | $49 | 2068% |
Consumer Guidance & Cost Commentary
For the CPT code 85018 (Blood test, hemoglobin) at Hodgeman County Health Center in Jetmore, KS, the facility's cash median rate of $42.00 is notably higher than the state average of $39.00. While the facility offers a government-owned Critical Access Hospital setting, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare and Medicaid/KanCare plans have negotiated ranges extending up to $49.00 and $52.00 respectively, which are higher than the cash price. This dynamic suggests that for patients with high-deductible plans or those without insurance, paying the cash rate directly might result in lower out-of-pocket costs compared to having insurance cover the service, provided the patient understands their specific plan's allowed amount.
To ensure you are not overcharged, it is advisable to request a detailed itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should explicitly ask about "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims cycle. If you encounter a balance bill from an out-of-network provider, such as for unexpected ancillary lab services, you may be protected under the No Surprises Act, which prohibits balance billing for emergency and non-emergency care at in-network facilities. Always verify your deductible status and request a self-pay classification prior to scheduling to avoid automatic claims submission that could void potential cash discounts.