Blood test, hemoglobin
Facility: Amberwell Atchison Association
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $10
- Cash Discount Price: $21
- vs. Medicare Baseline: 4.22x 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 422% of the Medicare baseline (a markup of 322%). 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 |
|---|---|---|
| Triwest - All Plans | $5 - $9 | 211% |
| Superior Select Mcr Adv - All Plans | $5 - $9 | 211% |
| UnitedHealthcare | $5 - $54 | 211% |
| Humana | $5 - $13 | 211% |
| Va Ccn - All Plans | $5 - $9 | 211% |
| Ambetter / Centene | $7 - $14 | 295% |
| Cigna | $8 - $15 | 338% |
| Aetna | $8 - $15 | 338% |
| Blue Cross Blue Shield | $9 - $10 | 380% |
| Oscar - All Plans | $10 - $21 | 422% |
| Centrus Health Direct - All Plans | $10 - $21 | 422% |
| Multiplan - All Plans | $11 - $22 | 464% |
| Wppa Providrs Care - All Plans | $13 - $25 | 549% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the facility's cash price of $21.00 is identical to the cash median for Atchison County and the state of Kansas. While many insurance plans negotiate rates that exceed this cash price, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurer's negotiated rate is higher than $21.00. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the Medicare benchmark of $2.37 for this service, which serves as a more accurate reflection of the facility's true cost.
Before scheduling, patients should verify their specific plan's deductible status and request a "self-pay" or "prompt-pay" discount, which can reduce the bill by 20% to 50%. If you are using insurance, ensure you receive an itemized bill rather than a summary invoice, as hospitals sometimes bundle charges or include services not rendered. If you encounter a balance bill from an out-of-network provider at an in-network facility, you may be protected under the No Surprises Act, which bans surprise billing for emergency and non-emergency services; in such cases, you should dispute the bill in writing rather than paying immediately to avoid unexpected costs.