CMS Price Transparency Data

Blood test, hemoglobin

Facility: Wilkes Regional Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $19
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 8.02x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Wilkes Regional Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 8.02x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.
Cash / Self-Pay
$19

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: $19 (802%)
Insurance Median: $19 (802%)
Cash: $19 (802% 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
Healthteam $2 84%
Alliance $4 169%
Amerihealth $4 - $22 169%
Carolina Complete $4 169%
Healthblue $4 169%
Partners $4 169%
Trillium $4 169%
UnitedHealthcare $4 - $20 169%
Vaya $4 169%
Wellcare $4 169%
Medcost $11 - $27 464%
Aetna $14 - $26 591%
Blue Cross Blue Shield $15 - $22 633%
Ambetter / Centene $18 - $23 759%
Cigna $20 - $21 844%
Oscar $21 - $25 886%
Directnet $22 928%
Private Healthcare Systems $34 1435%
Multiplan $35 1477%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1370 West D St, North Wilkesboro, NC 28659
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals