CMS Price Transparency Data

Blood test, hemoglobin

Facility: Golden Valley Memorial Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $2
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Golden Valley Memorial Hospital is $2. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 0.84x the Medicare baseline. Located in 1600 N 2Nd St, Clinton, MO.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$2

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: $36 (1519%)
Insurance Median: $2 (84%)
Cash: $36 (1519% of Medicare)
Ins. Median: $2 (84% 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.

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 84%
Home State Health $2 84%
Humana $2 84%
UnitedHealthcare $2 - $4 84%
Ambetter / Centene $3 127%

Consumer Guidance & Cost Commentary

Golden Valley Memorial Hospital in Clinton, Missouri, reports a cash median price of $36 for the blood test for hemoglobin (CPT code 85018). This cash rate is significantly lower than the facility's gross charge of $61 and aligns closely with the state of Missouri average, which stands at $36. For patients with high-deductible plans, paying the cash price of $36 upfront may be more cost-effective than using insurance, as the commercial negotiated rates for this service are $2, which appears to be the baseline allowed amount across all listed payers including Aetna, Home State Health, Humana, UnitedHealthcare, and Ambetter/Centene.

The facility operates under a government hospital district or authority and maintains a rating of 3 out of 5. While the median negotiated rate is $2, patients should be aware that this amount often represents the baseline for in-network coverage rather than the final out-of-pocket cost, as many plans require meeting a deductible before these negotiated rates apply. To minimize expenses, it is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the bill by bypassing administrative claim processing fees. Additionally, patients should request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final invoice.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N 2Nd St, Clinton, MO 64735
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals