CMS Price Transparency Data

Blood test, hemoglobin

Facility: Sanford Chamberlain Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $51
Cash Discount Price: $55
vs. Medicare Baseline: 21.52x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Sanford Chamberlain Medical Center is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 21.52x the Medicare baseline. Located in 300 S Byron, Chamberlain, SD.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $55 (2321%)

Insurance Median: $51 (2152%)

Cash: $55 (2321% of Medicare)

Ins. Median: $51 (2152% 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 2152% of the Medicare baseline (a markup of 2052%). 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
Sanford Health Plan Align	$24	1013%
Ucare	$25 - $61	1055%
Wellmark Sd	$25 - $60	1055%
Aetna	$26 - $60	1097%
Health Partners	$26 - $52	1097%
Medicare (plans)	$26	1097%
Primewest	$26	1097%
UnitedHealthcare	$26 - $58	1097%
Sanford Health Plan	$38 - $51	1603%
Security Health Plan	$38	1603%
Medica	$57 - $61	2405%
First Choice Health Network	$62	2616%
Healthez	$62	2616%
Multiplan	$62	2616%

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 $55.
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 Sanford Chamberlain Medical Center 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.