CMS Price Transparency Data

Blood test, hemoglobin

Facility: Essentia Health

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $25
  • Cash Discount Price: $34
  • vs. Medicare Baseline: 10.55x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Essentia Health is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 10.55x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$34

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $34 (1435%)
Insurance Median: $25 (1055%)
Cash: $34 (1435% of Medicare)
Ins. Median: $25 (1055% 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 1055% of the Medicare baseline (a markup of 955%). 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
Advocare/Security Health $2 84%
Blue Cross Blue Shield $2 - $31 84%
Freedom Blue Ppo $2 84%
Healthpartners Care Msho / Mcr Adv $2 84%
Imcare Msho Pcc Prime $2 84%
Imcare Msho Ref Req $2 84%
Itasca Med Care $2 84%
Medica Advantage Solutions $2 84%
Medica Msho/Dual Solutions $2 84%
Medica Prime Solution Group $2 84%
Medicare (plans) $2 84%
Nd Va Administration $2 84%
Platinum Blue/Vantage Blue $2 84%
Primewest $2 84%
Primewest Msho $2 84%
Secure Blue Msho $2 84%
Ubh Cost Plan $2 84%
Ubh Msho $2 84%
Ucare Msho $2 84%
UnitedHealthcare $2 - $37 84%
Sanford Health Plan $8 - $21 338%
Medica Access $12 506%
Healthpartners Care Pmap $18 759%
Medica $25 - $28 1055%
Medica Uplan $25 1055%
Medica Choice $29 1224%
Cigna $30 - $31 1266%
Healthpartners $30 - $31 1266%
Healthpartners Pcc Prime $30 - $31 1266%
Ucare $30 1266%
Wea $32 - $35 1350%
America'S Ppo $35 - $36 1477%
Wps $37 - $39 1561%
Aetna $38 - $39 1603%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals