CMS Price Transparency Data

Blood test, hemoglobin

Facility: Tomah Memorial Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $22
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 9.28x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Tomah Memorial Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 9.28x the Medicare baseline. Located in 501 Gopher Dr, Tomah, WI.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $38 (1603%)
Insurance Median: $22 (928%)
Cash: $38 (1603% of Medicare)
Ins. Median: $22 (928% 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 928% of the Medicare baseline (a markup of 828%). 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
Va Ccn - All Plans $2 84%
Blue Cross Blue Shield $8 - $60 338%
Independent Care Mcaid $8 338%
Managed Hlth Mcaid - All Plans $8 338%
Quartz Mcaid $8 338%
Security Hp Mcaid $8 338%
Group Hlth Mcr Adv - All Plans $22 928%
Humana $22 - $61 928%
Independent Care Mcr - All Other Plans $22 928%
Quartz Mcr Adv $22 928%
Security Hp Mcr Adv $22 928%
UnitedHealthcare $22 - $62 928%
Aetna $43 - $56 1814%
Cigna $50 - $64 2110%
Security Hp Comm - All Other Plans $56 2363%
Quartz Comm - All Other Plans $59 2489%
The Alliance - All Plans $61 2574%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Gopher Dr, Tomah, WI 54660
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals