Blood test, hemoglobin
Facility: Mitchell County Hospital Health Systems
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $37
- Cash Discount Price: $36
- 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 |
|---|---|---|
| UnitedHealthcare | $2 - $41 | 84% |
| Blue Cross Blue Shield | $10 | 422% |
| Triwest Well Mark All Plans | $33 - $35 | 1392% |
| Pref Hlth Care Sytms Comm - All Plans | $35 - $37 | 1477% |
| Aetna | $35 - $37 | 1477% |
| First Health-All Plans | $35 - $37 | 1477% |
| Multiplan Ppo - All Plans | $37 - $39 | 1561% |
| Phc Leased Ntwrk Access - All Plans | $37 - $39 | 1561% |
| Auxiant-All Plans | $37 - $39 | 1561% |
| Cigna | $39 - $41 | 1646% |
| Health Partners Ks-All Plans | $39 - $41 | 1646% |
Consumer Guidance & Cost Commentary
For the blood test for hemoglobin (CPT 85018) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's negotiated rates range from $2 to $41 depending on your specific insurance plan. While the cash price is $36.00, which is lower than the gross charge of $40.00, commercial insurance contracts often result in higher out-of-pocket costs due to administrative fees and contract structures. It is important to note that for patients with high-deductible plans, paying the cash price of $36.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates paid by insurers can sometimes exceed the cash price. Additionally, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these can further reduce the final amount owed.
This facility, a Critical Access Hospital with government-local ownership, has a facility rating of 3. When comparing pricing benchmarks, the facility's cash rate of $36.00 is notably higher than the state of Kansas average, which is $2.37. However, the facility's negotiated rate of $37.00 aligns closely with the state median negotiated rate of $37.00. To ensure you are receiving fair pricing, it is recommended to request an itemized billing audit to review all charges line-by-line, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Always compare your specific plan's allowed amount against the Medicare benchmark of $2.37 to understand the true cost basis of the service.