CMS Price Transparency Data

Blood test, hemoglobin

Facility: Lafayette Regional Health Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $54
Cash Discount Price: $117
vs. Medicare Baseline: 22.78x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Lafayette Regional Health Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 22.78x the Medicare baseline. Located in 1500 State Street, Lexington, MO.

Cash / Self-Pay

$117

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $117 (4937%)

Insurance Median: $54 (2278%)

Cash: $117 (4937% of Medicare)

Ins. Median: $54 (2278% 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 2278% of the Medicare baseline (a markup of 2178%). 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
Aetna	$2 - $124	84%
Amerigroup	$2	84%
Healthyblue	$2	84%
Home State Health Plan	$2	84%
Medicaid / KanCare	$2	84%
Unicare	$2	84%
United	$2 - $64	84%
Corvel Corporation	$5 - $121	211%
Oha Network	$5 - $71	211%
Ambetter / Centene	$17 - $26	717%
Nhc Advantage	$17 - $27	717%
Universal Healthcare	$24 - $37	1013%
Humana	$31 - $61	1308%
Blue Cross Blue Shield	$35 - $142	1477%
College Park Family Care Center	$39 - $61	1646%
Oscar	$46 - $71	1941%
Cigna	$52 - $101	2194%
Wppa Providrs Care Network	$68 - $107	2869%
Multiplan	$71 - $111	2996%
Coventry	$73 - $113	3080%
Coventry Kc Mo	$73 - $113	3080%
Cco, Inc.	$77 - $121	3249%
Focus Healthcare Mgmt, Inc	$82 - $128	3460%

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 $117.
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 Lafayette Regional Health 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.