Blood test, hemoglobin
Facility: Clay County Medical Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $42
- Cash Discount Price: $45
- vs. Medicare Baseline: 17.72x 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 1772% of the Medicare baseline (a markup of 1672%). 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 |
|---|---|---|
| Health Partners - All Plans | $32 - $53 | 1350% |
| UnitedHealthcare | $32 - $53 | 1350% |
| Aetna | $32 - $52 | 1350% |
| Wppa/Providrs Care- All Plans | $32 - $52 | 1350% |
| Multiplan- All Plans | $32 - $53 | 1350% |
Consumer Guidance & Cost Commentary
For the blood test (CPT 85018) at Clay County Medical Center in Clay Center, KS, the cash median price is $45.00, which matches the facility's negotiated rate of $42.00 and the state average. This service is billed under the Critical Access Hospital designation, and while the facility is government-owned, patients should be aware that commercial insurance negotiated rates for this code range from $32.00 to $53.00 across five major payers, including Health Partners, UnitedHealthcare, and Aetna. Because the cash price is identical to the negotiated rate, patients with high-deductible plans may find paying out-of-pocket directly at the time of service to be the most cost-effective option, potentially avoiding the administrative overhead associated with insurance claims processing.
To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to note that the Medicare benchmark for this procedure is $2.37, which serves as the objective baseline for fair pricing; commercial rates are significantly higher than this federal standard, reflecting the administrative costs and risk premiums built into insurance contracts. If you receive a bill that exceeds the cash price or the negotiated range, you should request a full itemized audit to verify that no unbundled codes or services not rendered have inflated the total, ensuring you are only paying for the actual care provided.