CMS Price Transparency Data

Blood test, hemoglobin

Facility: Hospital of Univ of Pennsylvania

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $12
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 5.06x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Hospital of Univ of Pennsylvania is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 5.06x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $74 (3122%)
Insurance Median: $12 (506%)
Cash: $74 (3122% of Medicare)
Ins. Median: $12 (506% 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 506% of the Medicare baseline (a markup of 406%). 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
Cigna $1 - $59 42%
Gspp And Wissahickon Hospice $1 42%
Paired Kidney Exchange $1 - $11 42%
Blue Cross Blue Shield $2 - $52 84%
Devoted Health $2 84%
Geisinger Health Plan $2 - $8 84%
Health Partners $2 - $132 84%
Humana $2 - $106 84%
Ibc $2 84%
Kaiser Permanente $2 - $132 84%
Medicare (plans) $2 84%
Pa Health And Wellness $2 - $4 84%
Penn Life (Living Independently For Elders) $2 84%
Philadelphia Va Medical Center $2 84%
UnitedHealthcare $2 - $132 84%
Upmc $2 - $132 84%
Aetna $3 - $132 127%
Clover Health Plan $3 127%
Elap $3 127%
Gateway Health Plan $3 127%
Horizon Nj Health $3 - $23 127%
Ibc Commercial Hpn $3 127%
Keystone First $3 127%
Keystone Hmo Proactive $3 127%
Medicaid / KanCare $3 - $132 127%
Pa Medical Assistance $3 - $132 127%
Pgm - Regie De L'Assurance Maladie Quebec $3 - $30 127%
Preferred Health Care Eliance $3 - $29 127%
Tricare $3 127%
Us Family Health Plan $3 127%
Centivo $4 169%
Claims Watcher $4 169%
Elap Services $4 169%
Keystone Mercy Health Plan $4 - $132 169%
Oscar Health Plan $4 169%
Highmark $5 211%
Pgm - Kuwait Defense $5 - $59 211%
Coventry $6 - $67 253%
Olympus $6 - $52 253%
Penn Global Medicine $6 253%
Pgm - Chop $6 - $53 253%
Qualcare $6 - $50 253%
Wissahickon Hospice $6 - $53 253%
Healthamerica/Coventry $7 - $65 295%
First Health Global $8 - $66 338%
Health Net $9 - $79 380%
Pgm - Royal Embassy Of Saudi Arabia $9 - $79 380%
Interlink $10 - $88 422%
Pgm - Embassy Of Qatar $10 - $86 422%
Pgm - Embassy Of The United Emirates/Ipc $10 - $92 422%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $10 - $86 422%
Health America/Ccn $12 - $106 506%
Intergroup $12 - $106 506%
Pgm - Kuwait Health Division $12 - $106 506%
Pgm - Kuwait Oil $12 - $106 506%
Preferred Care $12 - $106 506%
Blue Quality Centers For Transplant (Bqct) $15 - $132 633%
City Of Philadelphia Behavioral Health $15 - $132 633%
Commercial Other $15 - $132 633%
International Pfs $15 - $132 633%
United Behavioral Health $15 - $132 633%
Workers Compensation $15 - $132 633%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals