CMS Price Transparency Data

Blood test, hemoglobin

Facility: Ohio Valley Surgical Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $11,885
  • Cash Discount Price: $42
  • vs. Medicare Baseline: 5014.77x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Ohio Valley Surgical Hospital is $11,885. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 5014.77x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$42

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,885

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: $42 (1772%)
Insurance Median: $11,885 (501477%)
Cash: $42 (1772% of Medicare)
Ins. Median: $11,885 (501477% 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 501477% of the Medicare baseline (a markup of 501377%). 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 - $40,293 84%
Aetna $3 - $20,896 127%
Geha $3 - $20,896 127%
Genworth $3 - $20,896 127%
Mail Handlers $3 - $20,896 127%
Meritain $3 - $20,896 127%
Meritain Heatlh $3 - $20,896 127%
Mhbp $3 - $20,896 127%
Ngs Coresource $3 - $20,896 127%
Nippon Life $3 - $20,896 127%
Pacific Source $3 - $20,896 127%
Personify Health $3 - $20,896 127%
UnitedHealthcare $3 - $17,571 127%
Mmo Cin. Hmo $32 - $44 1350%
Mmoh $32 - $11,885 1350%
Mmoh (Supermed) $32 - $33 1350%
Medicare (plans) $42 - $12,264 1772%
Luminare Health $63 2658%
Medben $63 2658%
Ohio Health $63 2658%
Preferred Health $63 2658%
Medicaid / KanCare $3,557 - $17,827 150084%
Amerihealth Caritas Of Ohio $3,657 154304%
Buckeye Community Health Plan $4,022 169705%
Molina Mcd $4,084 172321%
Caresource $4,364 - $17,827 184135%
Humana $4,493 - $11,919 189578%
Aarp $11,885 501477%
Aarp Supplemental $11,885 501477%
American Continental Insurance $11,885 501477%
American Continental Life $11,885 501477%
American Republic $11,885 501477%
American Retirement $11,885 501477%
Aultcare Primetime Health Plan $11,885 501477%
Bankers Fidelity $11,885 501477%
Bankers Life And Casualty $11,885 501477%
Central States $11,885 501477%
Champus $11,885 501477%
Cigna $11,885 - $18,817 501477%
Communicare Advantage $11,885 501477%
Everest $11,885 501477%
Gateway Health Plan $11,885 501477%
Medigold $11,885 501477%
Molina $11,885 501477%
Molina Dual Mcr $11,885 501477%
Molina Marketplace $11,885 501477%
Molina Dual Mcr $11,885 501477%
Molina Mcr $11,885 501477%
Molina Mcr Mcd $11,885 501477%
Molina Mcr+Mcd $11,885 501477%
Patient No Pay $11,885 501477%
Prosperity Supplement $11,885 501477%
Self Pay Imaging $11,885 501477%
Wellcare By Allwell $11,885 501477%
Wraparound Pl Supp $11,885 501477%
The Health Plan $12,479 526540%
Devoted Health $13,707 578354%
Employer Direct $15,703 662574%
Golden Rule $17,571 741392%
Medica $17,571 741392%
Oxford $17,571 741392%
Shl $17,571 741392%
Surest $17,571 741392%
Ushealth $17,571 741392%
Caresourse $17,827 752194%
Healthgram $18,817 793966%
Nalc $18,817 793966%
Samba $18,817 793966%
Sbma $18,817 793966%
Unified Group $18,817 793966%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals