CMS Price Transparency Data

Blood test, hemoglobin

Facility: Wooster Community Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $11
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 4.64x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Wooster Community Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 4.64x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $14 (591%)
Insurance Median: $11 (464%)
Cash: $14 (591% of Medicare)
Ins. Median: $11 (464% 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 464% of the Medicare baseline (a markup of 364%). 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
Blue Cross Blue Shield $2 - $8 84%
Buckeye Mcare $2 84%
Caresource Mcr Adv $2 84%
Humana $2 - $13 84%
Med Mutual Of Oh Mcr $2 84%
Molina Mcr $2 84%
Summacare Mcr $2 84%
The Health Plan Mcr Adv $2 84%
Tricare $2 84%
UnitedHealthcare $2 - $13 84%
Valor Hp Mcr-All Plans $2 84%
Caresource Exch - All Other Plans $3 127%
Magnipower-All Plans $3 127%
Molina Marketplace - All Other Plans $4 169%
Clarity Health - All Plans $5 211%
Aultcare/Primecare Mcr Adv $7 295%
Buckeye Mcaid-All Other Plans $7 295%
Caresource Mcaid $7 295%
Aetna $8 - $14 338%
Amerihealth Mcaid-All Plans $8 338%
Molina Mcaid $8 338%
Aultcare Wayne County $10 422%
Aultcare/Primetime Exch $10 422%
Cerco-All Plans $10 422%
Rayco-All Plans $10 422%
Christian Health Ministries-All Plans $11 464%
Cigna $11 464%
Health Ohio Network Employer $11 464%
Wayne County-All Plans $11 464%
Health Ohio Network Ppo-All Other Plans $12 506%
Health Plan Of Upper Ohio-All Plans $12 506%
Healthsmart Accel $12 506%
Healthsmart Complete Ppo-All Other Plans $12 506%
Med Mutual Of Oh Exchange $12 506%
Med Mutual Of Oh Supermed $12 506%
Med Mutual Of Oh Trad-All Other Plans $12 506%
Ohio Health Choice Supp $12 506%
Ohio Health Group Hlthy - All Other Plans $12 506%
Ohio Health Group Pref $12 506%
Summacare Preferred Choice $12 506%
The Health Plan Comm - All Other Plans $12 506%
Aultcare/Primetime-All Other Plans $13 549%
Central Benefits-All Plans $13 549%
First Health-All Plans $13 549%
Flora-All Plans $13 549%
Healthsmart Hpo $13 549%
Healthsmart Ppo $13 549%
Ohio Health Choice-All Other Plans $13 549%
Osu-All Plans $13 549%
Summacare-All Other Plans $13 549%
Beech Street-All Plans $14 591%
Phcs-All Plans $14 591%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals