CMS Price Transparency Data

Blood test, hemoglobin

Facility: Pennsylvania Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $40
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 16.88x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Pennsylvania Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 16.88x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $117 (4937%)
Insurance Median: $40 (1688%)
Cash: $117 (4937% of Medicare)
Ins. Median: $40 (1688% 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 1688% of the Medicare baseline (a markup of 1588%). 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 - $40 42%
Blue Cross Blue Shield $2 - $117 84%
Geisinger Health Plan $2 - $8 84%
Health Partners $2 - $117 84%
Humana $2 - $94 84%
Ibc $2 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%
Upmc $2 - $117 84%
Aetna $3 - $117 127%
Clover Health Plan $3 127%
Elap $3 127%
Gateway Health Plan $3 127%
Ibc Commercial Hpn $3 127%
Keystone First $3 127%
Keystone Hmo Proactive $3 127%
Medicaid / KanCare $3 - $117 127%
Pa Medical Assistance $3 127%
Tricare $3 127%
UnitedHealthcare $3 - $117 127%
Us Family Health Plan $3 127%
Centivo $4 169%
Claims Watcher $4 169%
Elap Services $4 169%
Keystone Mercy Health Plan $4 169%
Oscar Health Plan $4 169%
Highmark $5 211%
Penn Global Medicine $6 253%
Horizon Nj Health $20 - $21 844%
Pgm - Regie De L'Assurance Maladie Quebec $27 1139%
Preferred Health Care Eliance $30 1266%
Pgm - Kuwait Defense $41 - $53 1730%
Devon $44 - $53 1857%
Qualcare $44 1857%
Coventry $47 - $60 1983%
Pgm - Chop $47 1983%
Wissahickon Hospice $47 1983%
Healthamerica/Coventry $53 - $57 2236%
Olympus $57 2405%
First Health Global $58 2447%
Urn-Cancer Resource Services $58 2447%
Health Net $70 2954%
Pgm - Royal Embassy Of Saudi Arabia $70 2954%
Pgm - Embassy Of Qatar $76 3207%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $76 3207%
Pgm - Embassy Of The United Emirates/Ipc $82 3460%
Devon Health Services Inc $94 3966%
Health America/Ccn $94 3966%
Intergroup $94 3966%
Pgm - Kuwait Health Division $94 3966%
Pgm - Kuwait Oil $94 3966%
Preferred Care $94 3966%
Commercial Other $117 4937%
Community Behavioral Health $117 4937%
International Pfs $117 4937%
Quest Behavioral Health $117 4937%
United Behavioral Health $117 4937%
Workers Compensation $117 4937%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals