Blood test, hemoglobin
Facility: Regional Medical Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $870
- Cash Discount Price: $20
- vs. Medicare Baseline: 367.09x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 36709% of the Medicare baseline (a markup of 36609%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 36709% |
Consumer Guidance & Cost Commentary
Regional Medical Center in Manchester, IA, reported a cash median price of $20 for the blood test, hemoglobin procedure. This cash price is significantly lower than the facility's median negotiated rate of $870 and the Medicare amount of $2.37. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that cash payments may offer a much lower out-of-pocket cost compared to insurance claims, which often include administrative overhead.
For patients with high-deductible plans, paying the $20 cash rate directly can be more cost-effective than relying on the insurance negotiated rate of $870, especially if the plan has not yet met its deductible. It is important to verify the facility's "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill. Additionally, since the Medicare amount of $2.37 serves as a federal benchmark for the true cost of delivery, the commercial negotiated rate represents a substantial markup, highlighting the value of comparing rates against this baseline rather than the hospital's full chargemaster list.