CMS Price Transparency Data

Blood test, hemoglobin

Facility: North Austin Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $6
  • Cash Discount Price: $249
  • vs. Medicare Baseline: 2.53x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at North Austin Medical Center is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 2.53x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$249

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $249 (10506%)
Insurance Median: $6 (253%)
Cash: $249 (10506% of Medicare)
Ins. Median: $6 (253% 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 253% of the Medicare baseline (a markup of 153%). 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 - $73 84%
Cigna $2 - $7 84%
Devoted Health $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 Healthcare Alliance $2 84%
United $2 - $112 84%
UnitedHealthcare $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%
Oscar $7 295%
Moda $59 2489%
Covenant Management Systems $72 3038%
Healthcare Highways $72 - $75 3038%
Imo Med - Select Network $75 3165%
Nomi Health $80 - $92 3376%
Moda Health $90 - $92 3797%
Evry Health $92 3882%
Texas Healthcare Foundation Heb $92 3882%
Texas Workforce Commission $97 4093%
Harbor Health Team $100 4219%
Averde Health $112 4726%
Comanche County $124 5232%
National Choicecare $124 5232%
Healthsmart Preferred Care $137 - $199 5781%
Independent Medical Systems $137 5781%
Physicians Cooperative Of Texas $137 5781%
Prime Health $149 6287%
First Health $156 - $177 6582%
Coastal Comp Health Networks $162 6835%
National Health Care $162 6835%
Texas Municipal League $174 7342%
Medcorp Southwest $187 7890%
Rockport Healthcare Group $199 - $224 8397%
Bce Emergis Corporation $224 9451%
Beech Street $224 9451%
Medical Control Network Solutions $224 9451%
Multiplan $224 9451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals