Blood test, hemoglobin
Facility: Syracuse Area Health
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $164
- Cash Discount Price: $171
- vs. Medicare Baseline: 69.20x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 6920% of the Medicare baseline (a markup of 6820%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medica | $150 | 6329% |
| UnitedHealthcare | $162 | 6835% |
| Blue Cross Blue Shield | $164 | 6920% |
| Midlands Choice | $164 | 6920% |
| Aetna | $166 | 7004% |
| First Health Network | $168 | 7089% |
Consumer Guidance & Cost Commentary
Syracuse Area Health, a Critical Access Hospital in Syracuse, Nebraska, performed a blood test for hemoglobin (CPT code 85018) for a cash price of $171. This facility is owned by a Government Hospital District or Authority. While the cash rate is provided, specific negotiated rates for individual payers are not available in the current data. The data indicates that the cash price of $171 is higher than the median negotiated rate of $164 reported for this procedure.
Patients should be aware that cash-paying for this service may sometimes result in a lower out-of-pocket cost than using insurance if the insurance negotiated rate exceeds the cash price, though the data shows the cash rate is currently the highest figure listed. It is important to note that commercial negotiated rates often include administrative overhead and can be inflated by 20% to 40% compared to true cost baselines. Consumers are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full upfront, and to request an itemized bill to ensure no errors or unbundled charges are present before finalizing payment.