CMS Price Transparency Data

Blood test, hemoglobin

Facility: The Children's Mercy Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $18
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 7.59x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at The Children's Mercy Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 7.59x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.
Cash / Self-Pay
$13

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $13 (549%)
Insurance Median: $18 (759%)
Cash: $13 (549% of Medicare)
Ins. Median: $18 (759% 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 759% of the Medicare baseline (a markup of 659%). 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
Healthy Blue $2 - $6 84%
Medicaid / KanCare $2 84%
UnitedHealthcare $2 - $19 84%
Home State Health $6 253%
Blue Cross Blue Shield $11 - $21 464%
Cigna $13 - $19 549%
Medica $16 675%
Aetna $17 - $19 717%
Centivo $18 759%
Health Midwest Comprehensive Care $18 759%
Nebraska Furniture Mart $18 759%
Orscheln $18 759%
Quiktrip $18 759%
Wellfit/Centrus $18 759%
Wppa Providrs Care $18 759%
Humana $19 802%
Coventry Health Care Of Kansas $21 886%
Coxhealth Network $21 886%
Mercy Health $21 886%
Multiplan $21 886%
American Healthcare Alliance $24 1013%
Healthlink $25 1055%
National Preferred Provider Network $25 1055%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2401 Gillham Road, Kansas City, MO 64108
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens