CMS Price Transparency Data

Blood test, hemoglobin

Facility: Reston Hospital Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $9
Cash Discount Price: $94
vs. Medicare Baseline: 3.80x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Reston Hospital Center is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 3.80x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $94 (3966%)

Insurance Median: $9 (380%)

Cash: $94 (3966% of Medicare)

Ins. Median: $9 (380% 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 380% of the Medicare baseline (a markup of 280%). 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
Aetna	$2	84%
Blue Cross Blue Shield	$2 - $12	84%
Cigna	$2 - $9	84%
Clear Spring Health Plan	$2	84%
Davita Village Health	$2	84%
Devoted	$2	84%
Humana	$2 - $3	84%
Johns Hopkins	$2	84%
Sentara Health	$2	84%
United	$2 - $42	84%
Virginia Premier Health	$2	84%
Align Senior Care	$3	127%
Pyramid Life	$3	127%
Bright Health	$5	211%
Carefirst	$13	549%
Lifeworks	$18	759%
Universal Healthcare Group	$21	886%
Greenvbrier Sporting Club	$56	2363%
Corvel	$67	2827%
Virginia Health Network	$67	2827%
Occunet Workers Comp	$75	3165%
4Most Health Network	$84	3544%

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 $94.
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 Reston Hospital 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.