CMS Price Transparency Data

Blood test, hemoglobin

Facility: UPMC Kane

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $19
Cash Discount Price: $31
vs. Medicare Baseline: 8.02x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at UPMC Kane is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 8.02x the Medicare baseline. Located in 4372 Route 6, Kane, PA.

Cash / Self-Pay

$31

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $31 (1308%)

Insurance Median: $19 (802%)

Cash: $31 (1308% of Medicare)

Ins. Median: $19 (802% 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 802% of the Medicare baseline (a markup of 702%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UPMC Work Partners	$2	84%
Focus Healthcare	$3 - $49	127%
UnitedHealthcare	$3 - $21	127%
UPMC Health Plan	$4 - $23	169%
Aetna	$4 - $20	169%
Geisinger	$4	169%
Amerihealth Caritas	$5 - $21	211%
Highmark Wholecare (Prev Gateway)	$5 - $21	211%
PA Health & Wellness	$6	253%
Blue Cross Blue Shield	$10 - $19	422%
Horizon Health Plan	$36	1519%
Cigna	$36 - $1,171	1519%
Multiplan	$39	1646%
Intergroup	$42	1772%
Health Coalition Partners	$42	1772%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $31.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85018.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Kane is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85018.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.