CMS Price Transparency Data

Blood test, hemoglobin

Facility: Hermann Area District Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $23
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 9.70x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Hermann Area District Hospital is $23. 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 9.70x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $23 (970%)
Cash: $19 (802% of Medicare)
Ins. Median: $23 (970% 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 970% of the Medicare baseline (a markup of 870%). 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
Coventry - All Plans $2 84%
UnitedHealthcare $4 - $39 169%
Tricare $12 - $37 506%
Choicecare Mcr Adv- All Plans $13 - $39 549%
Cigna $13 - $38 549%
Aetna $14 - $88 591%
American Hlth Mcr Adv- All Plans $14 - $41 591%
Blue Cross Blue Shield $14 - $75 591%
Humana $14 - $41 591%
Wellcare Mcr Adv - All Plans $14 - $42 591%
Harmony Hp Mcaid- All Plans $18 - $54 759%
Healthcare Usa Mcaid- All Plans $20 - $60 844%
Healthlink Hmo $20 - $60 844%
Ambetter / Centene $22 - $65 928%
Healthlink Ppo - All Other Plans $23 - $69 970%
Multiplan/Phcs - All Plans $23 - $69 970%
Comp Results - All Plans $28 - $83 1181%
Three Rivers - All Plans $28 - $83 1181%
Care Partners Mcaid- All Plans $31 - $92 1308%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals