CMS Price Transparency Data

Blood test, hemoglobin

Facility: Children's Hospital of Philadelphia

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $68
Cash Discount Price: $139
vs. Medicare Baseline: 28.69x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Children's Hospital of Philadelphia is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 28.69x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$139

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $139 (5865%)

Insurance Median: $68 (2869%)

Cash: $139 (5865% of Medicare)

Ins. Median: $68 (2869% 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 2869% of the Medicare baseline (a markup of 2769%). 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
Geisinger Medical Assistance	$4	169%
Horizon Nj Health	$4	169%
Highmark Wholecare	$5	211%
Medicaid / KanCare	$20 - $60	844%
UnitedHealthcare	$20 - $200	844%
Health Partners	$23 - $68	970%
Aetna	$29 - $182	1224%
Upmc Medical Assistance	$34 - $99	1435%
Keystone First Chip	$38 - $113	1603%
Keystone Health Plan East	$39 - $115	1646%
Blue Cross Blue Shield	$44 - $145	1857%
Geisinger Health Plan Commercial	$54 - $160	2278%
Jefferson Health Plans	$58 - $172	2447%
Cigna	$62 - $182	2616%
Highmark	$62 - $182	2616%
Qualcare	$68 - $200	2869%
First Health Network	$80 - $236	3376%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$99 - $290	4177%
Private Health Care Systems	$99 - $290	4177%
Choice Care Network	$111 - $327	4684%

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 $139.
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 Children's Hospital of Philadelphia 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.