CMS Price Transparency Data

Blood test, hemoglobin

Facility: St David's South Austin Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $38
  • Cash Discount Price: $237
  • vs. Medicare Baseline: 16.03x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at St David's South Austin Medical Center is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 16.03x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$237

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $237 (10000%)
Insurance Median: $38 (1603%)
Cash: $237 (10000% of Medicare)
Ins. Median: $38 (1603% 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 1603% of the Medicare baseline (a markup of 1503%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $2 - $20 84%
American Health Plan Of Texas $2 84%
Blue Cross Blue Shield $2 - $79 84%
Cigna $2 - $72 84%
Devoted Health $2 84%
Harbor Hospice $2 84%
Humana $2 84%
Molina Healthcare $2 - $3 84%
Odyssey Hospice $2 84%
Sendero $2 - $4 84%
Shared Health $2 84%
St David’S Hospice $2 84%
Superior Health Plan $2 - $42 84%
Triwest Veterans $2 84%
United $2 - $112 84%
Wellmed $2 84%
Amerigroup $3 127%
Austin Fc $3 127%
Imperial Insurance $3 127%
Provider Partners Health Plan $3 127%
Pyramid Life $3 127%
Texas Independent Health Plan $3 127%
Triwest Health Alliance $3 127%
Universal Health $3 127%
Wellcare $3 127%
Naphcare $4 169%
Seven Corners $4 169%
Corvel Corporation $5 211%
UnitedHealthcare $6 - $248 253%
Oscar $7 295%
Moda $53 - $58 2236%
Covenant Management Systems $65 - $71 2743%
Healthcare Highways $66 - $74 2785%
Imo Med - Select Network $68 - $74 2869%
Nomi Health $72 - $92 3038%
Moda Health $81 - $92 3418%
Evry Health $83 - $91 3502%
Texas Healthcare Foundation Heb $84 - $92 3544%
Texas Workforce Commission $88 - $97 3713%
Harbor Health Team $90 - $99 3797%
Averde Health $102 - $112 4304%
Comanche County $113 - $124 4768%
Emerging Therapy Solutions $113 - $171 4768%
National Choicecare $113 - $124 4768%
Healthsmart Preferred Care $124 - $198 5232%
Independent Medical Systems $124 - $136 5232%
Physicians Cooperative Of Texas $124 - $136 5232%
Prime Health $136 - $149 5738%
First Health $142 - $178 5992%
Coastal Comp Health Networks $147 - $161 6203%
National Health Care $147 - $161 6203%
Occunet $158 - $174 6667%
Texas Municipal League $158 - $174 6667%
Medcorp Southwest $170 - $186 7173%
Preferred Health Arrangement $170 - $186 7173%
Rockport Healthcare Group $181 - $223 7637%
Bce Emergis Corporation $203 - $223 8565%
Beech Street $203 - $223 8565%
Medical Control Network Solutions $203 - $223 8565%
Multiplan $203 - $223 8565%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals