Blood test, hemoglobin
Facility: Fredonia Regional Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $14
- Cash Discount Price: $16
- vs. Medicare Baseline: 5.91x 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 591% of the Medicare baseline (a markup of 491%). 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 |
|---|---|---|
| Veterans Programs - All Plans | $8 | 338% |
| Blue Cross Blue Shield | $8 - $10 | 338% |
| Aetna | $8 - $15 | 338% |
| Cigna | $14 - $15 | 591% |
| Reserve National-All Plans | $14 - $15 | 591% |
| UnitedHealthcare | $14 - $15 | 591% |
| Meritain-All Plans | $14 - $15 | 591% |
Consumer Guidance & Cost Commentary
For CPT code 85018, a blood test for hemoglobin at Fredonia Regional Hospital in Fredonia, Kansas, the cash price is $16.00, which matches the facility's median negotiated rate of $14.00 and the state average. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this specific case, the cash price is actually lower than the median negotiated rate of $14.00, meaning self-pay patients may save money by paying directly rather than relying on insurance reimbursement, especially if their plan has a high deductible.
The Medicare benchmark for this service is $2.37, highlighting a significant markup on the federal baseline. Although the facility's cash rate is higher than the Medicare amount, it remains competitive compared to the broader market. Patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than the cash price. To ensure you receive the best possible rate, contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill.