CMS Price Transparency Data

Blood test, hemoglobin

Facility: Carilion Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $31
Cash Discount Price: $18
vs. Medicare Baseline: 13.08x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Carilion Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 13.08x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $18 (759%)

Insurance Median: $31 (1308%)

Cash: $18 (759% of Medicare)

Ins. Median: $31 (1308% 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 1308% of the Medicare baseline (a markup of 1208%). 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	84%
Abh Of Va (Formerly Coventry)	$3	127%
Abh Of Wva (Formerly Coventry)	$3	127%
Humana	$3	127%
Sentara Health Plan	$3 - $31	127%
UnitedHealthcare	$3 - $41	127%
Aetna	$25 - $33	1055%
Gateway - Tier 3	$28	1181%
Vhn - Ultra	$31	1308%
Cigna	$34 - $36	1435%
Connecticare	$35	1477%
Vhn - Plus	$38	1603%
Gateway - Tier 2	$40	1688%
Vhn	$40	1688%
Vhn - Link	$45	1899%
Gateway - Tier 1	$48	2025%
Vhn - Secondary Payors	$48	2025%

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 $18.
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 Carilion 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.