CMS Price Transparency Data

Blood test, hemoglobin

Facility: Blue Ridge Regional Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $29
  • Cash Discount Price: $71
  • vs. Medicare Baseline: 12.24x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Blue Ridge Regional Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 12.24x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$71

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $71 (2996%)
Insurance Median: $29 (1224%)
Cash: $71 (2996% of Medicare)
Ins. Median: $29 (1224% 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 1224% of the Medicare baseline (a markup of 1124%). 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
Amerihealth $3 127%
Blue Cross Blue Shield $11 - $12 464%
United $12 - $34 506%
Wellcare $12 506%
Partners Health Management $13 549%
Vaya Health $13 549%
Apex Health $14 591%
Cigna $24 - $29 1013%
Amerihealth Caritas $26 1097%
Caresource $31 1308%
Medcost $33 - $37 1392%
Magellan $43 1814%
Magellan Behavioral Health $43 1814%
Aetna $51 2152%
Multiplan $57 2405%
Avalon Administrative Services $60 2532%
Prime Health $63 - $64 2658%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals