CMS Price Transparency Data

Blood test, hemoglobin

Facility: Sanford Wheaton Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $21
Cash Discount Price: $19
vs. Medicare Baseline: 8.86x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Sanford Wheaton Medical Center is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 8.86x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.

Cash / Self-Pay

$19

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: $19 (802%)

Insurance Median: $21 (886%)

Cash: $19 (802% 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.

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
Blue Cross Blue Shield	$6 - $22	253%
Sanford Health Plan Align	$12	506%
Aetna	$13 - $21	549%
Health Partners	$13 - $19	549%
Medicare (plans)	$13	549%
Primewest	$13 - $15	549%
Security Health Plan	$13	549%
Ucare	$13 - $21	549%
UnitedHealthcare	$13 - $20	549%
Sanford Health Plan	$19 - $22	802%
Medica	$21 - $23	886%
First Choice Health Network	$22	928%
Healthez	$22	928%
Multiplan	$22	928%

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 $19.
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 Sanford Wheaton Medical Center 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.