CMS Price Transparency Data

Blood test, hemoglobin

Facility: Adventist Health Portland

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $22
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 9.28x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Adventist Health Portland is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 9.28x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$12

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $12 (506%)
Insurance Median: $22 (928%)
Cash: $12 (506% of Medicare)
Ins. Median: $22 (928% 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 928% of the Medicare baseline (a markup of 828%). 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
Aetna $2 84%
Care Oregon - All Plans $2 84%
Healthnet Epo/Pos/Ppo $2 84%
Healthnet Hmo/Pos - All Other Plans $2 84%
Humana $2 - $3 84%
Kaiser Mcr Adv $2 84%
Ods - All Plans $2 84%
Pacific Source Comm - All Plans $2 84%
Providence Hp - All Plans $2 84%
Healthnet Mcr Adv $3 127%
Moda Mcr Adv $3 127%
UnitedHealthcare $3 - $99 127%
Ah Employee Health Plan - All Plans $4 169%
Moda Affinity - All Other Plans $5 211%
Moda Conn Oebb/Syn Pebb $5 211%
Cigna $6 253%
Kaiser - All Other Plans $6 253%
Regence Ohsu Plus $6 253%
Healthcare Resources - All Plans $7 - $15 295%
Moda Select $7 295%
Regence - All Other Plans $7 295%
Moda Connexus $8 338%
Moda Synergy $9 380%
Workers Comp $11 - $23 464%
Bc Premera First - All Plans $16 - $33 675%
Worldventure - All Plans $19 - $40 802%
Regence Preferred Mcr Adv $21 - $43 886%
First Choice - All Plans $22 - $46 928%
Multiplan - All Plans $24 - $50 1013%
Phcs - All Plans $24 - $50 1013%
Regence Mcr Adv $24 - $50 1013%
First Health-Coventry - All Plans $26 - $53 1097%
National Provider Network - All Plans $28 - $58 1181%
Health Payors Organization Ltd- All Plans $29 - $59 1224%
Moda Ohsu Ppo/Epo/Hmc $58 - $119 2447%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals