CMS Price Transparency Data
Blood test, hemoglobin
Facility: Mercy Hospital Springfield
Billing Code: 85018 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85018
- Insurance Median: $20
- Cash Discount Price: $43
- vs. Medicare Baseline: 8.44x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Mercy Hospital Springfield is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 8.44x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$43
Average discount available for prompt cash payment at this facility.
Insurance Median
$20
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: $43 (1814%)
Insurance Median: $20 (844%)
Cash: $43 (1814% of Medicare)
Ins. Median: $20 (844% 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 844% of the Medicare baseline (a markup of 744%). 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 |
|---|---|---|
| Aetna | $2 - $3 | 84% |
| Blue Cross Blue Shield | $2 - $53 | 84% |
| Centurion Of Missouri [20459] | $2 | 84% |
| Champva [20065] | $2 | 84% |
| Cherokee Nation Health Serv Contracted [320066] | $2 | 84% |
| Cigna | $2 - $13 | 84% |
| Cross Timbers Hospice [20098] | $2 | 84% |
| Dept Of Veteran Affairs Contracted [320106] | $2 | 84% |
| Elara Caring Aspire Hospice [20433] | $2 | 84% |
| Globalhealth Contracted [320145] | $2 | 84% |
| Halo Hcr Inc Hospice Contracted [320432] | $2 | 84% |
| Halo Hcr Inc Hospice [20432] | $2 | 84% |
| Humana | $2 - $48 | 84% |
| Indian Health Service Contracted [320198] | $2 | 84% |
| Indian Health Service [20198] | $2 | 84% |
| Kindful Hospice Contracted [320434] | $2 | 84% |
| Kindful Hospice [20434] | $2 | 84% |
| Medica Contracted [320239] | $2 | 84% |
| Medica [20239] | $2 | 84% |
| Medicaid / KanCare | $2 - $5 | 84% |
| Medicare (plans) | $2 | 84% |
| Mercy Hospice Okc [20252] | $2 | 84% |
| Mercy Mgd Behavioral Health Contracted [320259] | $2 | 84% |
| Mercy Rehab Hospital Contracted [320260] | $2 | 84% |
| Pace Of The Ozarks Contracted [320518] | $2 | 84% |
| Qual Choice Contracted [320325] | $2 | 84% |
| Tricare | $2 | 84% |
| United Medical Resources Contracted [320454] | $2 - $36 | 84% |
| UnitedHealthcare | $2 - $54 | 84% |
| Healthscope Contracted [320182] | $3 | 127% |
| Provider Partners Health Plans Contracted [320450] | $3 | 127% |
| Centivo Contracted [320505] | $4 | 169% |
| Providrs Care Network Contracted [320484] | $4 | 169% |
| Aither Health Contracted [320449] | $5 - $40 | 211% |
| Ambetter / Centene | $5 | 211% |
| Auxiant Contracted [320462] | $5 - $46 | 211% |
| Ebms Contracted [320493] | $5 | 211% |
| Healthlink Contracted [320179] | $5 - $14 | 211% |
| Home State Health Plan Contracted [320187] | $5 | 211% |
| Imagine 360 Contracted [320494] | $5 | 211% |
| Mercy Benefit Admin Contracted [320251] | $5 - $40 | 211% |
| Novasys Contracted [320285] | $5 | 211% |
| Reflect Health Contracted [320492] | $5 | 211% |
| Yuzu Health Contracted [320521] | $5 | 211% |
| 90 Degree Benefits Contracted [320436] | $14 | 591% |
| Show-Me Health Administrators Contracted [320483] | $14 - $15 | 591% |
| Benefit Management Contracted [320052] | $25 - $28 | 1055% |
| Health Systems Inc Contracted [320174] | $25 - $28 | 1055% |
| Insurance System Inc Contracted [320465] | $25 - $28 | 1055% |
| Administrative Payor Contracted [320005] | $28 - $35 | 1181% |
| Evolutions Health Care Contracted [320124] | $28 - $32 | 1181% |
| Point C Contracted [320238] | $28 - $52 | 1181% |
| Point C [20238] | $28 - $32 | 1181% |
| Medical Destinations Contracted [320242] | $32 - $35 | 1350% |
| Workers Comp [20426] | $32 - $60 | 1350% |
| First Health Contracted [320128] | $35 - $39 | 1477% |
| Edison Health Solutions Contracted [320502] | $36 - $40 | 1519% |
| Federal Medical Center Contracted [320127] | $38 - $42 | 1603% |
| Multiplan Contracted [320270] | $49 - $54 | 2068% |
| Private Health Care Systems Contracted [320320] | $49 - $54 | 2068% |
| American Healthcare Alliance Contracted [320020] | $50 - $56 | 2110% |
| Compcare Of The Ozarks Contracted [320437] | $50 - $55 | 2110% |
| Qual Choice Contracted [320324] | $50 - $56 | 2110% |
| Municipal Health Plan Contracted [320271] | $51 - $57 | 2152% |
| Usa Managed Care Org Contracted [320429] | $55 - $62 | 2321% |
| Ppo Plus Contracted [320310] | $57 - $63 | 2405% |