CMS Price Transparency Data

Blood test, hemoglobin

Facility: Montefiore Mount Vernon Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $2
  • Cash Discount Price: $21
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Montefiore Mount Vernon Hospital is $2. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 0.84x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$21

Average discount available for prompt cash payment at this facility.

Insurance Median
$2

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: $21 (886%)
Insurance Median: $2 (84%)
Cash: $21 (886% of Medicare)
Ins. Median: $2 (84% 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.

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
Amidacare $2 84%
Blue Cross Blue Shield $2 - $26 84%
Centerlight $2 84%
Emblem $2 - $26 84%
Fidelis $2 - $4 84%
Healthfirst $2 - $3 84%
Humana $2 84%
Longevity $2 84%
Medicaid / KanCare $2 84%
Point Comfort $2 84%
UnitedHealthcare $2 - $5 84%
Villagecaremax $2 84%
Vnsny Choice $2 84%
Vnsny Select Health $2 84%
Wellcare $2 84%
Metroplus $3 127%
Oscar $3 127%
Mvp $4 169%
American Postal Workers $5 211%
Aetna $11 - $12 464%
Centivo $21 886%
Cigna $23 - $26 970%
Elderplan $26 1097%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals