CMS Price Transparency Data

Blood test, hemoglobin

Facility: Atrium Health Cleveland

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $42
Cash Discount Price: $48
vs. Medicare Baseline: 17.72x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Atrium Health Cleveland is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 17.72x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

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: $48 (2025%)

Insurance Median: $42 (1772%)

Cash: $48 (2025% of Medicare)

Ins. Median: $42 (1772% 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 1772% of the Medicare baseline (a markup of 1672%). 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 - $74	84%
Cigna	$2 - $77	84%
Humana	$2	84%
UnitedHealthcare	$2 - $52	84%
Alliance	$3 - $16	127%
Amerihealth Caritas	$3 - $14	127%
Blue Cross Blue Shield	$3 - $40	127%
Carolina Complete Health	$3 - $14	127%
Choicecare	$3 - $79	127%
Healthy Blue	$3 - $14	127%
Partners	$3 - $14	127%
Trillium	$3 - $14	127%
Vaya	$3 - $14	127%
Wellcare	$3 - $14	127%
Ambetter / Centene	$31 - $35	1308%
Employers Health Network	$43 - $51	1814%
Physician Reach Out	$48	2025%
Medcost	$54 - $64	2278%
Magellan	$58	2447%
Gmmi	$63	2658%
Quik Trip	$63	2658%
Carolina Behavioral Health	$70 - $77	2954%
Healthgram	$77	3249%
First Health	$82	3460%
Lifesynch Community Choice Care	$82	3460%
Private Health Care Systems	$87	3671%
Beechstreet	$89	3755%
Multiplan	$92	3882%

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 $48.
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 Atrium Health Cleveland 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.