CMS Price Transparency Data

Blood test, hemoglobin

Facility: Texas Childrens Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $26
Cash Discount Price: $42
vs. Medicare Baseline: 10.97x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Texas Childrens Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 10.97x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $42 (1772%)

Insurance Median: $26 (1097%)

Cash: $42 (1772% of Medicare)

Ins. Median: $26 (1097% 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 1097% of the Medicare baseline (a markup of 997%). 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
Blue Cross Blue Shield	$2 - $42	84%
Community First Health Plan Mcd	$2 - $26	84%
Cook Children'S Health Plan	$2 - $26	84%
First Care Health Plan	$2 - $42	84%
Molina Mcd	$2 - $20	84%
Superior Chip	$2	84%
UnitedHealthcare	$2 - $42	84%
Cigna	$3 - $42	127%
Driscoll Children'S Health Plan Mcd	$3	127%
Aetna	$4 - $42	169%
Community Health Choice	$4 - $42	169%
Evolutions Healthcare	$4 - $50	169%
Healthsmart	$4 - $46	169%
Kelseycare	$4 - $43	169%
First Health	$5 - $63	211%
Multiplan	$5 - $59	211%
Galaxy Health Network	$6 - $63	253%

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 $42.
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 Texas Childrens Hospital 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.