CMS Price Transparency Data

Blood test, hemoglobin

Facility: Girard Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $14
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 5.91x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Girard Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 5.91x the Medicare baseline. Located in 302 North Hospital Drive, Girard, KS.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $24 (1013%)
Insurance Median: $14 (591%)
Cash: $24 (1013% of Medicare)
Ins. Median: $14 (591% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $10 - $14 422%
UnitedHealthcare $14 - $38 591%
Ambetter / Centene $14 591%
Medicare (plans) $14 591%
Aetna $14 - $70 591%
Kansas Superior Select-All Plans $14 591%
Humana $14 591%
Multiplan-All Plans $37 1561%
Uhhis-All Plans $38 1603%

Consumer Guidance & Cost Commentary

For the blood test for hemoglobin (CPT 85018) at Girard Medical Center in Girard, Kansas, the facility's cash median rate is $24.00, which is higher than the state average of $2.37 for Medicare-approved amounts. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $10 to $38, these amounts are often inflated by administrative overhead and contract structures that can exceed the true cost of care. It is important to note that for patients with high-deductible plans, paying the cash price of $24.00 upfront might be more cost-effective than relying on insurance, as the negotiated rates paid by insurers can sometimes be significantly higher than the cash price. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full before or shortly after the service.

When reviewing your bill, avoid comparing the hospital's gross charges to your savings, as these inflated list prices are not a valid benchmark for fair pricing. Instead, use the Medicare rate of $2.37 as the objective baseline to evaluate the facility's markup, which is a scientifically validated cost standard used by the federal government. If you receive a bill, request a detailed, itemized statement to identify any errors, double-billing, or services that were not rendered, as over 80% of hospital bills contain mistakes. Be cautious of summary bills that obscure individual costs, and if you are concerned about unexpected charges, remember that the No Surprises Act protects you from balance billing for out

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 302 North Hospital Drive, Girard, KS 66743
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals