Blood test, hemoglobin
Facility: Scott County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $34
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 14.35x 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 1435% of the Medicare baseline (a markup of 1335%). 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 |
|---|---|---|
| UnitedHealthcare | $2 - $36 | 84% |
| Blue Cross Blue Shield | $10 | 422% |
| Humana | $16 | 675% |
| Wppa | $23 - $1,200 | 970% |
| Aetna | $34 | 1435% |
Consumer Guidance & Cost Commentary
For this blood test for hemoglobin at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $10 to $1,200 depending on your specific insurance plan, with a median negotiated amount of $34.00. This price is notably higher than the Medicare benchmark of $2.37, reflecting the standard administrative markup inherent in commercial insurance contracts. While the facility is a Critical Access Hospital owned by a voluntary non-profit, patients should be aware that cash-pay options are not listed in the current data. However, if you have a high-deductible plan where your insurance allowed amount exceeds the cash price, paying out-of-pocket might be more cost-effective, provided you confirm the facility's self-pay or prompt-pay discounts before scheduling.
It is important to distinguish between the facility's gross charge of $38.00 and the actual amounts paid by insurers, which vary significantly across the five participating payers. For instance, UnitedHealthcare plans pay a median of $2, while WPPA plans can reach up to $1,200, illustrating how network tiering and contract dynamics influence final costs. If you receive a bill that appears to include balance billing for out-of-network services at this in-network facility, you may be entitled to protections under the No Surprises Act, which bans surprise bills for emergency care and non-emergency services at in-network hospitals. To ensure accuracy, always request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered.