CMS Price Transparency Data

Blood test, hemoglobin

Facility: Mainehealth Stephens Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $24
Cash Discount Price: $59
vs. Medicare Baseline: 10.13x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Mainehealth Stephens Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 10.13x the Medicare baseline. Located in 181 Main Street, Norway, ME.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $59 (2489%)

Insurance Median: $24 (1013%)

Cash: $59 (2489% of Medicare)

Ins. Median: $24 (1013% 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 1013% of the Medicare baseline (a markup of 913%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$2 - $54	84%
Blue Cross Blue Shield	$2 - $55	84%
Harvard Pilgrim Healthcare	$2 - $57	84%
Humana	$3 - $23	127%
UnitedHealthcare	$3 - $57	127%
Wellcare	$3 - $24	127%
Community Health Options	$5 - $56	211%
Cigna	$55	2321%
Multiplan	$56	2363%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $59.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85018.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mainehealth Stephens Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85018.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.