CMS Price Transparency Data

Blood test, hemoglobin

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $22
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 9.28x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Munson Healthcare Otsego Memorial Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 9.28x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $23 (970%)
Insurance Median: $22 (928%)
Cash: $23 (970% of Medicare)
Ins. Median: $22 (928% 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 928% of the Medicare baseline (a markup of 828%). 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 $1 - $17 42%
Mclaren Health Plan $1 - $23 42%
Meridian $1 42%
Molina $1 - $3 42%
Priority Health $1 - $8 42%
UnitedHealthcare $1 - $22 42%
Aetna $2 - $23 84%
Blue Care Network $2 84%
Cigna $2 - $8 84%
Hap (Health Alliance Plan) $2 - $22 84%
Humana $2 84%
Medicare (plans) $2 84%
Michigan Amish Medical Board $2 84%
Northern Michigan Mennonite Group $2 84%
Employee Benefit Logistics $4 169%
Hospice Of Michigan $16 - $17 675%
Munson Hospice $19 - $852 802%
Asr Physicians Care Network $22 928%
Enterprise Group Planning/Employee Benefit Plan $22 928%
Nomi Health $22 928%
Cofinity $23 - $25 970%
Provider Network Of America/Hawaii Mainland Administrative Group Health $23 - $24 970%
Three Rivers Provider Network $23 - $24 970%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals