CMS Price Transparency Data

Blood test, hemoglobin

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $3
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Hospital Pavia Hato Rey, Inc is $3. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 1.27x the Medicare baseline. Located in Ave Ponce De Leon 435, Hato Rey, PR.
Cash / Self-Pay
$13

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: $13 (549%)
Insurance Median: $3 (127%)
Cash: $13 (549% 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%
First Medical $2 - $5 84%
Medicare (plans) $2 84%
Mso $2 84%
Plan De Salud Menonita $2 - $3 84%
Triple S $2 - $6 84%
Va $2 84%
Aarp $3 127%
Ch $3 127%
Fondo Del Seguro Estado $3 127%
Humana $3 127%
Tricare $3 127%
Mapfre $4 169%
Mcs $4 169%
Prossam $4 169%
Bl $5 211%
Mc $5 211%
Privado $5 211%
Bella Vista $6 253%
Cigna $6 253%
Auxilio Salud Plus $7 295%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Ave Ponce De Leon 435, Hato Rey, PR 00919
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals