CMS Price Transparency Data

Blood test, hemoglobin

Facility: Oakleaf Surgical Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $2
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Oakleaf Surgical Hospital is $2. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 0.84x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$2

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: $36 (1519%)
Insurance Median: $2 (84%)
Cash: $36 (1519% of Medicare)
Ins. Median: $2 (84% 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.

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
Blue Cross Blue Shield $2 84%
Dean Health Plan $2 84%
Group Health Cooperative Of Eau Claire $2 84%
Healthpartners $2 84%
Humana $2 84%
Medica $2 84%
Quartz Health Solutions $2 84%
Security Health Plan Of Wi $2 84%
Ucare Wi $2 84%
UnitedHealthcare $2 84%

Consumer Guidance & Cost Commentary

For a blood test for hemoglobin at Oakleaf Surgical Hospital in Altoona, WI, the cash median price is $36. This cash rate is significantly lower than the facility's gross charge of $40 and stands in stark contrast to the state of Wisconsin average, where the median negotiated rate is $2 and the median paid amount is $32. While cash payment may appear higher than some state averages, it is often the most cost-effective option for patients with high-deductible plans, as insurance negotiated rates can sometimes exceed the cash price due to administrative overheads.

Patients should be aware that while the facility is an Acute Care Hospital owned by physicians, the specific pricing for this CPT code (85018) varies by payment method. The Medicare amount for this service is $2.37, which serves as a critical benchmark to understand the markup on commercial rates. If you are using insurance, your plan's allowed amount could be higher than the cash price of $36, potentially leading to balance billing if you are out-of-network or if ancillary services are not covered under the contract. To minimize costs, we recommend asking the hospital about self-pay or prompt-pay discounts before scheduling, as paying upfront can sometimes reduce the final bill by bypassing standard insurance billing cycles.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals