CMS Price Transparency Data

Blood test, hemoglobin

Facility: Hospital Metropolitano Dr Susoni

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $3
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Hospital Metropolitano Dr Susoni is $3. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 1.27x the Medicare baseline. Located in Calle Palma Num 55, Arecibo, PR.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$3

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: $25 (1055%)
Insurance Median: $3 (127%)
Cash: $25 (1055% of Medicare)
Ins. Median: $3 (127% 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.

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
Acaa $2 84%
Aarp $3 127%
Aetna $3 127%
Ch $3 127%
Comerciales $3 127%
Humana $3 127%
Mcs $3 - $5 127%
Medicare (plans) $3 127%
Mso $3 127%
Tricare $3 127%
Triple S $3 - $7 127%
Va $3 127%
Mapfre $4 169%
Prossam $4 169%
First Medical $5 211%
Hospicio $5 211%
Mc $5 211%
Plan De Salud Menonita $5 211%
Cigna $6 253%
Bl $7 295%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Calle Palma Num 55, Arecibo, PR 00612
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals