CMS Price Transparency Data

Blood test, hemoglobin

Facility: Harlem Hospital Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $45
Cash Discount Price: Unavailable
vs. Medicare Baseline: 18.99x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Harlem Hospital Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 18.99x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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%)

Insurance Median: $45 (1899%)

Ins. Median: $45 (1899% 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 1899% of the Medicare baseline (a markup of 1799%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$2 - $7	84%
Elderplan	$2	84%
Fidelis	$2 - $102	84%
Healthfirst	$2 - $102	84%
Magnacare	$3	127%
Oxford	$3	127%
United	$3 - $56	127%
Oscar	$4	169%
Centerlight	$5	211%
Carelon	$6 - $45	253%
Cigna	$6	253%
Wellcare	$6	253%
Emblem	$7 - $61	295%
Blue Cross Blue Shield	$8 - $102	338%
Local 1199	$8	338%
Multiplan	$8	338%
Villagecare Max	$8	338%
Vnsny	$8 - $46	338%
Metroplus	$44 - $102	1857%
Amidacare	$45	1899%
Senior Whole Health	$45	1899%
United Behavioral Health	$45 - $50	1899%
Affinity	$46 - $102	1941%
Carelon (Amida Care)	$46	1941%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85018.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Harlem Hospital Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85018.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.