CMS Price Transparency Data

Blood test, hemoglobin

Facility: Pioneer Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $48
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 20.25x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Pioneer Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 20.25x the Medicare baseline. Located in 301 W 7Th Ave, Big Timber, MT.
Cash / Self-Pay
$41

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $41 (1730%)
Insurance Median: $48 (2025%)
Cash: $41 (1730% of Medicare)
Ins. Median: $48 (2025% 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 2025% of the Medicare baseline (a markup of 1925%). 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
Blue Cross Blue Shield $23 - $42 970%
Health Info Net Mcr Adv $23 970%
Healtnet Federal-All Plans $23 970%
Humana $23 - $47 970%
Triwest Va Pccc-All Plans $23 970%
UnitedHealthcare $23 - $48 970%
Rocky Mountain Health Network-All Plans $36 1519%
Allegiance Provider-All Plans $43 1814%
Mountain Health Co-Op Hpn $45 1899%
6 Degrees Health-All Plans $48 2025%
Americas Choice-All Plans $48 2025%
City Of Billings-All Plans $48 2025%
Community Health Ntwk-All Plans $48 2025%
Ebms Select Care Network-All Plans $48 2025%
Fedmed Network-All Plans $48 2025%
First Choice Big Sky-All Plans $48 2025%
First Health-All Plans $48 2025%
Interwest Ppo $48 2025%
Mountain Health Co-Op-All Other Plans $48 2025%
Pacific Source-All Plans $48 2025%
Pacific Steel & Recycling-All Plans $48 2025%
Three Rivers-All Plans $48 2025%
Health Info Net Peak/Equity $49 2068%
Health Info Net Standard-All Other Plans $49 2068%
Mountain Health Co-Op Ppo/Pos $50 2110%
Interwest Health Traditional-All Other Plans $51 2152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 W 7Th Ave, Big Timber, MT 59011
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals