Blood test, hemoglobin
Facility: Morris County Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $19
- Cash Discount Price: $29
- vs. Medicare Baseline: 8.02x 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 802% of the Medicare baseline (a markup of 702%). 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 |
|---|---|---|
| Va Ccn-All Plans | $1 | 42% |
| Providrs Care (Wppa)(Nexus)-All Plans | $2 | 84% |
| Aetna | $8 | 338% |
| Blue Cross Blue Shield | $9 - $19 | 380% |
| Choice Care Mcr Adv-All Plans | $19 | 802% |
| UnitedHealthcare | $19 - $49 | 802% |
| Coventry Mcr | $19 | 802% |
| Cigna | $35 | 1477% |
| Multiplan-All Plans | $44 | 1857% |
| Coventry Comm-All Other Plans | $44 | 1857% |
Consumer Guidance & Cost Commentary
For the blood test procedure (CPT 85018) at Morris County Hospital in Council Grove, Kansas, the facility's cash median rate is $29.00, while the median negotiated rate for in-network insurance plans is $19.00. This data highlights a scenario where paying out-of-pocket can be more expensive than using insurance coverage, as the negotiated rate is lower than the cash price. However, for patients with high-deductible plans who have not yet met their out-of-pocket maximum, the $19.00 negotiated rate may still result in a higher total cost than the $29.00 cash price if the insurance allowed amount exceeds the cash rate. It is important to verify your specific plan's deductible status and allowed amounts before scheduling, as assuming that in-network coverage is always the cheapest option can lead to unexpected financial burdens.
The facility's pricing structure is benchmarked against federal standards, with a Medicare amount of $2.37 serving as the baseline for cost evaluation. While the facility is a Critical Access Hospital owned by the local government, the gross charge of $49.00 represents the full list price before any discounts or insurance negotiations. Patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price, and comparing these rates directly to the Medicare benchmark provides a clearer picture of the facility's markup than comparing them to the inflated chargemaster list. Additionally, if you are self-paying, you may be eligible for prompt-pay discounts by requesting a self-pay classification at registration, which can reduce the final bill by offering immediate liquidity incentives to the hospital.