CMS Price Transparency Data

Blood test, hemoglobin

Facility: PAM Rehabilitation Hospital of Allen

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $156
  • Cash Discount Price: $207
  • vs. Medicare Baseline: 65.82x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at PAM Rehabilitation Hospital of Allen is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $207. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 65.82x the Medicare baseline. Located in 1001 Raintree Circle, Allen, TX.
Cash / Self-Pay
$207

Average discount available for prompt cash payment at this facility.

Insurance Median
$156

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: $207 (8734%)
Insurance Median: $156 (6582%)
Cash: $207 (8734% of Medicare)
Ins. Median: $156 (6582% 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 6582% of the Medicare baseline (a markup of 6482%). 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
Superior Health $2 84%
America'S Choice Provider Network $145 6118%
Provider Network Of America $156 6582%
Quik Trip $156 6582%
Usa Managed Care Organization $156 6582%
Velocity Provider Ppo Network $156 6582%
Multiplan/Phcs $166 7004%
Prime Health Services $176 7426%
Medincrease $187 7890%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1001 Raintree Circle, Allen, TX 75013
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL