CMS Price Transparency Data

Blood test, hemoglobin

Facility: Mercy Hospital Carthage

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $19
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 8.02x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Mercy Hospital Carthage is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 8.02x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $20 (844%)
Insurance Median: $19 (802%)
Cash: $20 (844% of Medicare)
Ins. Median: $19 (802% 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 802% of the Medicare baseline (a markup of 702%). 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 - $30 84%
Blue Cross Blue Shield $2 - $9 84%
Humana $2 - $10 84%
Medicaid / KanCare $2 - $19 84%
Medicare (plans) $2 - $10 84%
United Medical Resources Contracted [320454] $3 - $31 127%
UnitedHealthcare $3 - $30 127%
Cherokee Nation Health Serv Contracted [320066] $7 - $9 295%
Cigna $7 - $31 295%
Cross Timbers Hospice [20098] $7 - $9 295%
Dept Of Veteran Affairs Contracted [320106] $7 - $9 295%
Elara Caring Aspire Hospice [20433] $7 - $9 295%
Globalhealth Contracted [320145] $7 - $9 295%
Halo Hcr Inc Hospice Contracted [320432] $7 - $9 295%
Halo Hcr Inc Hospice [20432] $7 - $9 295%
Indian Health Service Contracted [320198] $7 - $9 295%
Kindful Hospice Contracted [320434] $7 - $9 295%
Kindful Hospice [20434] $7 - $9 295%
Medical Associates Health Contracted [320444] $7 - $9 295%
Mercy Hospice Okc [20252] $7 - $9 295%
Mercy Mgd Behavioral Health Contracted [320259] $7 - $9 295%
Pace Of The Ozarks Contracted [320518] $7 - $9 295%
Provider Partners Health Plans Contracted [320450] $7 - $9 295%
Qual Choice Contracted [320325] $7 - $9 295%
Tricare $7 - $9 295%
Point C Contracted [320238] $9 - $31 380%
Administrative Payor Contracted [320005] $12 - $15 506%
Centivo Contracted [320505] $12 - $16 506%
Health Systems Inc Contracted [320174] $12 - $15 506%
Insurance System Inc Contracted [320465] $12 - $15 506%
Healthscope Contracted [320182] $14 - $18 591%
Ambetter / Centene $15 - $19 633%
Home State Health Plan Contracted [320187] $15 - $19 633%
Novasys Contracted [320285] $15 - $19 633%
Benefit Management Contracted [320052] $16 - $30 675%
Auxiant Contracted [320462] $18 - $29 759%
Healthlink Contracted [320179] $18 - $32 759%
Preferred Health Plan Contracted [320522] $18 - $22 759%
Workers Comp [20426] $22 - $34 928%
90 Degree Benefits Contracted [320436] $23 - $29 970%
Aither Health Contracted [320449] $23 - $29 970%
Ebms Contracted [320493] $23 - $29 970%
Edison Health Solutions Contracted [320502] $23 - $29 970%
Evolutions Health Care Contracted [320124] $23 - $30 970%
First Health Contracted [320128] $23 - $30 970%
Imagine 360 Contracted [320494] $23 - $29 970%
Medica Contracted [320239] $23 - $29 970%
Mercy Benefit Admin Contracted [320251] $23 - $31 970%
Multiplan Contracted [320270] $23 - $30 970%
Private Health Care Systems Contracted [320320] $23 - $30 970%
Reflect Health Contracted [320492] $23 - $29 970%
Show-Me Health Administrators Contracted [320483] $23 - $29 970%
Yuzu Health Contracted [320521] $23 - $29 970%
American Healthcare Alliance Contracted [320020] $24 - $31 1013%
Ppo Plus Contracted [320310] $24 - $31 1013%
Usa Managed Care Org Contracted [320429] $24 - $31 1013%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3125 Dr Russell Smith Way, Carthage, MO 64836
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals