CMS Price Transparency Data
Blood test, hemoglobin
Facility: Mercy Health Lakeshore Campus
Billing Code: 85018 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85018
- Insurance Median: $21
- Cash Discount Price: $16
- vs. Medicare Baseline: 8.86x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Mercy Health Lakeshore Campus is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 8.86x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$16
Average discount available for prompt cash payment at this facility.
Insurance Median
$21
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: $16 (675%)
Insurance Median: $21 (886%)
Cash: $16 (675% of Medicare)
Ins. Median: $21 (886% 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 886% of the Medicare baseline (a markup of 786%). 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 |
|---|---|---|
| Access Health | $2 | 84% |
| Aetna | $2 - $19 | 84% |
| Align Senior Care | $2 | 84% |
| Blue Care Network Advantage | $2 | 84% |
| Blue Cross Blue Shield | $2 - $21 | 84% |
| Correctional Recovery | $2 | 84% |
| Medicaid / KanCare | $2 | 84% |
| Medicare (plans) | $2 | 84% |
| Oscar | $2 | 84% |
| UnitedHealthcare | $2 - $22 | 84% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $3 | 127% |
| U Of M Health Plan | $4 - $21 | 169% |
| Vitalcore | $4 | 169% |
| Wellpath | $4 | 169% |
| Molina Marketplace | $10 | 422% |
| Hospice Of Michigan | $13 | 549% |
| Nomi Health | $13 | 549% |
| Hap | $18 | 759% |
| Geha | $19 - $22 | 802% |
| Meritain | $19 | 802% |
| Wc Accident Fund | $19 | 802% |
| Wc Advantage | $19 | 802% |
| Wc Aig | $19 | 802% |
| Wc Allied | $19 | 802% |
| Wc Amerisure | $19 | 802% |
| Wc Amtrust | $19 | 802% |
| Wc Asu Risk Mgt | $19 | 802% |
| Wc Berkley Admin | $19 | 802% |
| Wc Broadspire | $19 | 802% |
| Wc Bunch & Associates | $19 | 802% |
| Wc Ccmsi | $19 | 802% |
| Wc Emc Insurance Company | $19 | 802% |
| Wc Esis | $19 | 802% |
| Wc Fcci | $19 | 802% |
| Wc Federated | $19 | 802% |
| Wc Gallagher Bassett | $19 | 802% |
| Wc Genex Care For Ohio | $19 | 802% |
| Wc Guard Insurance Company | $19 | 802% |
| Wc Hartford | $19 | 802% |
| Wc Liberty Mutual | $19 | 802% |
| Wc Meijers | $19 | 802% |
| Wc Michigan | $19 | 802% |
| Wc Mitchell Frankenmuth | $19 | 802% |
| Wc Pma | $19 | 802% |
| Wc Sedgwick | $19 | 802% |
| Wc Sentry | $19 | 802% |
| Wc Travelers | $19 | 802% |
| Wc Tristar | $19 | 802% |
| Wc Walmart | $19 | 802% |
| Wc Zurich | $19 | 802% |
| Asr Health Benefits | $20 | 844% |
| 1199 National Benefit Fund | $21 | 886% |
| Acclaim | $21 | 886% |
| Administrative Concepts | $21 | 886% |
| Allegeant | $21 | 886% |
| Allied Benefit Systems | $21 | 886% |
| Allied National Global Care | $21 | 886% |
| Ameriben | $21 | 886% |
| American Family | $21 | 886% |
| American Healthcare Alliance | $21 | 886% |
| American Republic | $21 | 886% |
| Amerihealth | $21 | 886% |
| Asrm - Reliance Standard Life Insurance | $21 | 886% |
| Aultcare | $21 | 886% |
| Automated Benefit Services | $21 | 886% |
| Auxiant | $21 | 886% |
| Bcn Domestic | $21 | 886% |
| Benefit Administrative Systems,Llc | $21 | 886% |
| Blue Benefit Administrators Of Massachusetts | $21 | 886% |
| Blue Care Network | $21 | 886% |
| Blue Distinction Transplant | $21 | 886% |
| Blue Shield - Ca | $21 | 886% |
| Blue Shield - Id (Regence) | $21 | 886% |
| Blue Shield - Ny Highmark Northeastern | $21 | 886% |
| Blue Shield - Ny Highmark Western | $21 | 886% |
| Blue Shield - Pa (Highmark) | $21 | 886% |
| Blue Shield - Wa (Regence) | $21 | 886% |
| Boon Chapman | $21 | 886% |
| Cam Administrative Services | $21 | 886% |
| Christian Brother Services | $21 | 886% |
| Christian Brothers Holy Cross | $21 | 886% |
| Christian Care Ministry | $21 | 886% |
| Cigna | $21 | 886% |
| Claimchoice Adminstrators | $21 | 886% |
| Comprehensive Benefits | $21 | 886% |
| Consociate | $21 | 886% |
| Continental Life Insurance | $21 | 886% |
| Custom Benefit Administrators | $21 | 886% |
| Cypress Benefit Administrators | $21 | 886% |
| Dean Health | $21 | 886% |
| Employee Benefit Concepts | $21 | 886% |
| Employee Benefit Management | $21 | 886% |
| Enterprise Group Planning | $21 | 886% |
| Fallon Health | $21 | 886% |
| Family Life Insurance Company | $21 | 886% |
| Forest County Potawatomi | $21 | 886% |
| Freedom Life Insurance Company | $21 | 886% |
| Ghc Scw | $21 | 886% |
| Group Administrators | $21 | 886% |
| Group Marketing Services | $21 | 886% |
| Group Pension Administrators | $21 | 886% |
| Guardian | $21 | 886% |
| Health America | $21 | 886% |
| Health Choices | $21 | 886% |
| Health Smart | $21 | 886% |
| Healthez | $21 | 886% |
| Healthgram | $21 | 886% |
| Healthscope | $21 | 886% |
| Humana | $21 | 886% |
| Insight | $21 | 886% |
| Intercare | $21 | 886% |
| International Benefit Administrators | $21 | 886% |
| Jfp Benefit Management | $21 | 886% |
| Jp Farley Corporation | $21 | 886% |
| Kaiser Domestic | $21 | 886% |
| Key Benefit Administrator | $21 | 886% |
| Liberty Union Life Assurance Co | $21 | 886% |
| Lifetime Benefit Solutions | $21 | 886% |
| Lucent Health | $21 | 886% |
| Luminare Health | $21 | 886% |
| Luminare Health (Detroit) | $21 | 886% |
| Manhattan Life | $21 | 886% |
| Medben | $21 | 886% |
| Medcost | $21 | 886% |
| Medi Share | $21 | 886% |
| Medical Mutual | $21 | 886% |
| Multiplan | $21 | 886% |
| Mutual Health Services | $21 | 886% |
| Mutual Of Omaha | $21 | 886% |
| Mvp | $21 | 886% |
| Ncas | $21 | 886% |
| Nippon Life Ins | $21 | 886% |
| Nova | $21 | 886% |
| Pai | $21 | 886% |
| Painters Union Insurance Fund | $21 | 886% |
| Pan-American Life | $21 | 886% |
| Paramount Hmo | $21 | 886% |
| Phcs | $21 | 886% |
| Physicians Mutual | $21 | 886% |
| Plumbers Local 98 Insurance Fund | $21 | 886% |
| Prairie States | $21 | 886% |
| Primary Physician Care | $21 | 886% |
| Professional Benefit Administrators | $21 | 886% |
| Secureone Preferred United Plans | $21 | 886% |
| The Loomis Company | $21 | 886% |
| Trinity Health Share | $21 | 886% |
| Trustmark Small Business Benefits | $21 | 886% |
| Unicare | $21 | 886% |
| Unified Group Services | $21 | 886% |
| Us Health And Life | $21 | 886% |
| Valenz | $21 | 886% |
| Varipro | $21 | 886% |
| Western & Southern Financial Group | $21 | 886% |
| Wps | $21 | 886% |
| First Health | $22 | 928% |
| Priority Health | $22 | 928% |