Blood test, hemoglobin
Facility: Memorial Hospital
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $16
- Cash Discount Price: $29
- vs. Medicare Baseline: 6.75x 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 675% of the Medicare baseline (a markup of 575%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $7 | 295% |
| Humana | $14 | 591% |
| Tricare | $14 | 591% |
| Medicare (plans) | $15 | 633% |
| Ambetter / Centene | $16 | 675% |
| Coventry - All Other Plans | $26 | 1097% |
| Preferred Healthcare-All Plans | $28 | 1181% |
| Health Partners Of Kansas - All Plans | $28 | 1181% |
| Wppa/Providers Care-All Plans | $41 | 1730% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Memorial Hospital in Abilene, KS, the cash price is $29.00, which matches the facility's cash median. While the hospital's negotiated rate for in-network payers averages $16.00, this amount is significantly higher than the Medicare benchmark of $2.37, reflecting the typical commercial markup structure where negotiated rates often range from 200% to 300% of the federal baseline. Because the cash price ($29.00) is lower than the median negotiated rate ($16.00) for most commercial plans, patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find paying cash directly more cost-effective than using insurance, provided they can secure the cash price without incurring balance billing.
Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the $29.00 cash price by bypassing administrative claim processing costs. It is important to verify the specific allowed amount for your plan, as commercial rates vary by carrier; for instance, while Blue Cross Blue Shield and Humana have a negotiated rate of $16.00, other payers like Coventry and Preferred Healthcare have rates of $28.00. Given that the facility is a Critical Access Hospital owned by a Government Hospital District, consumers should request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies, and should never pay a surprise balance bill if the No Surprises Act protections apply to their situation.