Blood test, hemoglobin
Facility: Northeast Regional Medical Center
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $46
- Cash Discount Price: $51
- vs. Medicare Baseline: 19.41x 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 1941% of the Medicare baseline (a markup of 1841%). 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 |
|---|---|---|
| Node Hospice Non Par Agree | $2 | 84% |
| Medicaid / KanCare | $2 - $3 | 84% |
| Blue Pathway/Pathway X | $2 | 84% |
| Tricare | $2 | 84% |
| Veterans Eval Services | $2 | 84% |
| Node VA | $2 | 84% |
| Node Devoted Health McR Adv | $2 | 84% |
| Blue Prefrerred | $2 | 84% |
| Medicare (plans) | $2 | 84% |
| Node Champva | $2 | 84% |
| UnitedHealthcare | $2 - $96 | 84% |
| Blue Cross Blue Shield | $2 - $39 | 84% |
| Blue Access | $2 | 84% |
| Centurion Correctional | $3 | 127% |
| Us Department of Labor | $3 | 127% |
| Home State Exchange | $4 | 169% |
| Naphcare | $4 | 169% |
| Immergrun | $5 | 211% |
| Self Pay | $31 - $71 | 1308% |
| Cigna | $44 - $50 | 1857% |
| Aetna | $48 - $107 | 2025% |
| Access Health Services, LLC | $83 | 3502% |
| Multiplan | $96 - $103 | 4051% |
| Healthlink | $96 - $103 | 4051% |
| Coventry Wc | $103 | 4346% |
Consumer Guidance & Cost Commentary
For this blood test for hemoglobin at Northeast Regional Medical Center in Kirksville, MO, the most significant benchmark is the Medicare amount of $2.37, which serves as the federal baseline for fair pricing. The facility's gross charge is listed at $128, representing a markup of 19.4 times the Medicare rate, while the median cash payment is $51 and the median negotiated rate is $46. This data indicates that paying cash or through a negotiated contract is substantially lower than the full list price, though the cash rate remains nearly 54 times higher than the Medicare benchmark.
Patients should be aware that while the facility offers a cash median of $51, many insurance plans have negotiated rates that can exceed this amount, particularly for payers like Aetna and UnitedHealthcare where high and low rates vary significantly across different plans. To maximize savings, consumers should explicitly request a prompt-pay discount or self-pay classification before scheduling, as waiting until after receiving a bill often forfeits these upfront payment incentives. Furthermore, if a patient's insurance allows a higher negotiated rate than the cash price, paying the cash rate of $51 directly could result in immediate cost savings, provided they have the funds available and do not need the insurance coverage for other services.